Hypoxic pulmonary vasoconstriction (HPV) is a physiological response to a decrease in airway O 2 tension, but the underlying mechanism is incompletely understood. We studied the contribution of glucose-6-phosphate dehydrogenase (Glc-6-PD), an important regulator of NADPH redox and production of reactive oxygen species, to the development of HPV. We found that hypoxia (95% N 2 , 5% CO 2 ) increased contraction of bovine pulmonary artery (PA) precontracted with KCl or serotonin. Depletion of extracellular glucose reduced NADPH, NADH, and HPV, substantiating the idea that glucose metabolism and Glc-6-PD play roles in the response of PA to hypoxia. Our data also show that inhibition of glycolysis and mitochondrial respiration (indicated by an increase in NAD ؉ and decrease in the ATP-to-ADP ratio) by hypoxia, or by inhibitors of pyruvate dehydrogenase or electron transport chain complexes I or III, increased generation of reactive oxygen species, which in turn activated Glc-6-PD. Inhibition of Glc-6-PD decreased Ca 2؉ sensitivity to the myofilaments and diminished Ca 2؉ -independent and -dependent myosin light chain phosphorylation otherwise increased by hypoxia. Silencing Glc-6-PD expression in PA using a targeted small interfering RNA abolished HPV and decreased extracellular Ca 2؉ -dependent PA contraction increased by hypoxia. Similarly, Glc-6-PD expression and activity were significantly reduced in lungs from Glc-6-PD mut(؊/؊) mice, and there was a corresponding reduction in HPV. Finally, regression analysis relating Glc-6-PD activity and the NADPH-to-NADP ؉ ratio to the HPV response clearly indicated a positive linear relationship between Glc-6-PD activity and HPV. Based on these findings, we propose that Glc-6-PD and NADPH redox are crucially involved in the mechanism of HPV and, in turn, may play a key role in increasing pulmonary arterial pressure, which is involved in the development of pulmonary hypertension.Pulmonary hypertension (PH) 2 is a major cause of morbidity and mortality, the incidence of which is increasing around the world. The mechanisms underlying the development of PH remain unclear, however, and current medical treatment is inadequate. That said, it has been noted that in people living at high altitude and in patients suffering from chronic obstructive pulmonary disease, the chronic reduction in inhaled O 2 induces sustained hypoxic pulmonary vasoconstriction (HPV), which eventually leads to development of PH (1, 2). HPV is a phenomenon that balances the ventilation-to-respiration quotient by constricting the pulmonary artery (PA) and redirecting blood flow in the lungs in response to local reductions in inspired pO 2 (3). Since its discovery nearly a century ago, numerous studies have been conducted to identify the mechanisms responsible for HPV. To date, however, no unifying mechanism has been identified. In 1982, McMurtry et al. (4) proposed that inhibition of glycolysis and oxidative phosphorylation mimics HPV and suggested that inhibition of the mitochondrial electron transport chain...