Our aim was to isolate the independent effects of 1) inspiratory muscle work (Wb) and 2) arterial hypoxemia during heavy-intensity exercise in acute hypoxia on locomotor muscle fatigue. Eight cyclists exercised to exhaustion in hypoxia [inspired O2 fraction (FIO 2 ) ϭ 0.15, arterial hemoglobin saturation (SaO 2 ) ϭ 81 Ϯ 1%; 8.6 Ϯ 0.5 min, 273 Ϯ 6 W; Hypoxia-control (Ctrl)] and at the same work rate and duration in normoxia (SaO 2 ϭ 95 Ϯ 1%; Normoxia-Ctrl). These trials were repeated, but with a 35-80% reduction in Wb achieved via proportional assist ventilation (PAV). Quadriceps twitch force was assessed via magnetic femoral nerve stimulation before and 2 min after exercise. The isolated effects of Wb in hypoxia on quadriceps fatigue, independent of reductions in SaO 2 , were revealed by comparing Hypoxia-Ctrl and Hypoxia-PAV at equal levels of SaO 2 (P ϭ 0.10). Immediately after hypoxic exercise potentiated twitch force of the quadriceps (Qtw,pot) decreased by 30 Ϯ 3% below preexercise baseline, and this reduction was attenuated by about one-third after PAV exercise (21 Ϯ 4%; P ϭ 0.0007). This effect of Wb on quadriceps fatigue occurred at exercise work rates during which, in normoxia, reducing Wb had no significant effect on fatigue. The isolated effects of reduced SaO 2 on quadriceps fatigue, independent of changes in Wb, were revealed by comparing Hypoxia-PAV and Normoxia-PAV at equal levels of Wb. Qtw,pot decreased by 15 Ϯ 2% below preexercise baseline after Normoxia-PAV, and this reduction was exacerbated by about one-third after Hypoxia-PAV (Ϫ22 Ϯ 3%; P ϭ 0.034). We conclude that both arterial hypoxemia and Wb contribute significantly to the rate of development of locomotor muscle fatigue during exercise in acute hypoxia; this occurs at work rates during which, in normoxia, Wb has no effect on peripheral fatigue. work of breathing; arterial oxygen content; altitude; limb blood flow; expiratory flow limitation ON THE BASIS OF STUDIES that mimicked the work of breathing (W b ) obtained during heavy and maximum exercise (1, 2) and unloaded the W b in maximal exercise (34), it has been estimated that the oxygen cost of breathing or the cardiac output devoted to the respiratory muscles approximates 10 -16% of maximal O 2 consumption (V O 2max ) or maximal cardiac output in healthy trained and untrained subjects. More direct microsphere measurements of blood flow distribution during maximal exercise in equines also showed that ϳ15-16% of cardiac output was distributed to the inspiratory and expiratory muscles of the chest wall and abdomen (47). One mechanism protecting blood flow to the respiratory muscles in heavy exercise may be the respiratory muscle metaboreflex, which has been shown to cause sympathetically mediated vasoconstriction of the exercising limb vasculature during heavy exercise in the face of developing inspiratory or expiratory muscle fatigue (32,56,57,59).We (4 -6) and others (48, 53, 62) have shown previously that whole body exercise in acute hypoxia significantly increases the rate of develo...