Burkholderia mallei and B. pseudomallei cause glanders and melioidosis, respectively, in humans and animals. A hallmark of pathogenesis is the formation of granulomas containing multinucleated giant cells (MNGCs) and cell death. These processes depend on type 6 secretion system 1 (T6SS-1), which is required for virulence in animals. We examined the cell biology of MNGC formation and cell death. We found that chloroquine diphosphate (CLQ), an antimalarial drug, inhibits Burkholderia growth, phagosomal escape, and subsequent MNGC formation. This depends on CLQ's ability to neutralize the acid pH because other alkalinizing compounds similarly inhibit escape and MNGC formation. CLQ inhibits bacterial virulence protein expression because T6SS-1 and some effectors of type 3 secretion system 3 (T3SS-3), which is also required for virulence, are expressed at acid pH. We show that acid pH upregulates the expression of Hcp1 of T6SS-1 and TssM, a protein coregulated with T6SS-1. Finally, we demonstrate that CLQ treatment of Burkholderiainfected Madagascar hissing cockroaches (HCs) increases their survival. This study highlights the multiple mechanisms by which CLQ inhibits growth and virulence and suggests that CLQ be further tested and considered, in conjunction with antibiotic use, for the treatment of diseases caused by Burkholderia.KEYWORDS Burkholderia, Madagascar hissing cockroaches, type 3 secretion system, type 6 secretion system, acidification, actin tails, autophagy, chloroquine, multinucleated giant cells, phagosomal escape B urkholderia mallei, a Gram-negative facultative intracellular bacterium, causes glanders, a disease that is acquired from exposure to infected solipeds. It is a hostadapted clone of B. pseudomallei and an obligate animal pathogen that has lost its capacity to survive in the environment through genomic decay (1). In contrast, B. pseudomallei is a soil saprophyte endemic in Southeast Asia and northern Australia (2). B. pseudomallei infects a broad range of hosts, from plants to humans, a consequence of its 7.2-Mbp genome shaped by horizontal gene acquisition (3). B. pseudomallei causes melioidosis, a disease that is marked by latency, reminiscent of the diseases caused by other granuloma-forming pathogens, such as Mycobacterium tuberculosis (4). Because of a natural resistance to multiple antibiotics, a lack of effective vaccines, a high risk of fatality, and a potential to be weaponized, the two pathogens are listed as tier 1 select agents (www.selectagents.gov/SelectAgentsandToxinsList.html).A related species that was formerly classified as B. pseudomallei, B. thailandensis exhibits a high degree of genomic similarity to B. pseudomallei and occupies the same