An established paradigm in pre-mRNA splicing is the recognition of the 59 splice site (59ss) by canonical basepairing to the 59 end of U1 small nuclear RNA (snRNA). We recently reported that a small subset of 59ss base-pair to U1 in an alternate register that is shifted by 1 nucleotide. Using genetic suppression experiments in human cells, we now demonstrate that many other 59ss are recognized via noncanonical base-pairing registers involving bulged nucleotides on either the 59ss or U1 RNA strand, which we term ''bulge registers.'' By combining experimental evidence with transcriptome-wide free-energy calculations of 59ss/U1 base-pairing, we estimate that 10,248 59ss (~5% of human 59ss) in 6577 genes use bulge registers. Several of these 59ss occur in genes with mutations causing genetic diseases and are often associated with alternative splicing. These results call for a redefinition of an essential element for gene expression that incorporates these registers, with important implications for the molecular classification of splicing mutations and for alternative splicing.[Keywords: 59 splice site; U1 small nuclear RNA; base-pairing register; bulged nucleotide; splicing mutation; alternative splicing] Supplemental material is available for this article. Pre-mRNA splicing is an essential processing step for the expression of ;90% of protein-coding human genes and relies on conserved sequence elements at both ends of introns, termed splice sites (Sheth et al. 2006;Wahl et al. 2009). These elements are highly diverse, considering that thousands of different sequences act as naturally occurring splice sites in the human transcriptome (Sahashi et al. 2007;Roca and Krainer 2009). The characterization of these sequence elements and the factors that recognize them has been essential for predicting exons in new genes, for the study of alternative splicing (Nilsen and Graveley 2010), and for classifying mutations in these elements that cause human genetic diseases (Buratti et al. 2007).Typically, the strength of a splice site (or splice site score) is estimated by algorithms that measure its concordance to matrices built using large collections of splice sites (Senapathy et al. 1990;Brunak et al. 1991;Yeo and Burge 2004;Sahashi et al. 2007;Hartmann et al. 2008). These methods implicitly assume that all of the sequences used to build the matrix are recognized by the same mechanism. However, there are cases in which the splice site score does not reflect the strength of the splice site determined experimentally (Roca and Krainer 2009), highlighting the limitations of these tools. Furthermore, the recognition mechanisms for many splice sites predicted to be weak are poorly understood.Splicing of >99% of pre-mRNA introns is catalyzed by the major spliceosome, a dynamic macromolecular machine composed of five small nuclear RNAs (snRNAs) and associated polypeptides, plus many other protein factors (Wahl et al. 2009). The U1 small nuclear ribonucleoprotein particle (snRNP), comprising the U1 snRNA and 10 polypeptides (Pomeranz K...