Tetanus toxin (TT) was used as a diagnostic marker for human neuroblastoma (NB) cells. TT binding sites visualized by TT and FITC-conjugated anti-TT antibodies were present on NB cells from all 13 cases studied comprising Stages II, III, IV, IVS and histologic grades 1 through 3. NB cells from both bone marrow aspirates and tumor biopsies as well as cultured NB cells were TT-positive. Diagnosis of NB was further ascertained by electron microscopy, cell culture, and quantitative determinations of catecholamines in tumor material. Only electron microscopic diagnoses had an accuracy comparable to that of TT labeling. None of the non-NB tumors (Ewing's sarcoma, acute lymphatic and myeloic leukemia, acute monocyte leukemia, chronic myeloic leukemia, Hodgkin's disease, oat cell carcinoma of the lung, pheochromocytoma), except for the pheochromocytoma, were found to bind TT specifically. These results suggest that TT may be profitably employed as a diagnostic marker of human NB cells. The advantages of the methods are its high discriminative capacity against non-NB cells and rapid applicability.