1. When human blood platelets were incubated aerobically in plasma containing 2 x 10-7 to 10-3M radioactive guanethidine for 10 min to 6 hr, the drug was accumulated against a concentration gradient until concentration ratios (platelet/plasma) of up to 80: 1 were obtained. 2. The decline in rate of uptake after 3 hr appeared to result from a decrease in platelet viability, because accumulation was reduced by prolonged incubation before addition of guanethidine. 3. Uptake was energy-dependent because it was inhibited by cold and ouabain. 4. Sodium ions were essential for guanethidine uptake and retention of 5-hydroxytryptamine (5-HT). 5. Accumulation was inhibited by 5-HT, desipramine, cocaine, dexamphetamine, bretylium, tyramine and noradrenaline; bethanidine, p-chlorophenylalanine and (-)-a-methyldopa were inactive. 6. Guanethidine was tightly bound to platelets, only 10% being lost from labelled cells during 60 min incubation in drug-free plasma; but efflux was increased by addition of amphetamine. 7. The binding sites for guanethidine seemed to be different from those for 5-HT since guanethidine accumulation was independent of 5-HT levels, and neither guanethidine uptake or release were affected by reserpine. 8. Guanethidine was not metabolized by platelets or plasma in vitro. 9. We consider that, if our results regarding uptake, binding and release of guanethidine are confirmed in vivo, and also found to apply to other pharmacologically active agents, then the eventual loss of a platelet-bound substance may increase pharmacological action by raising plasma levels.Although there is considerable information concerning the mechanisms of uptake and sites of storage of 5-hydroxytryptamine (5-HT) and noradrenaline (NA) by blood platelets, the fact that platelets can also accumulate a wide variety of other substances such as procaine, histamine, reserpine, quinidine, amino-acids, sugars Guanethidine uptake by platelets and diuretic drugs has only recently been demonstrated (Solomon & Zieve, 1967;Zieve & Solomon, 1967.Recent work indicates that in several respects the blood platelet resembles the sympathetic nerve ending. Although 5-HT is the'predominant amine in platelets and sympathetic nerves contain only NA, both structures preferentially accumulate the respective amine by an energy-dependent mechanism and store it in sub-cellular vesicles which show a dense core under the electron microscope (for references see Potter, 1967;Pletscher, 1968). As the uptake of guanethidine by sympathetic nerves is well established (for references see Boullin, 1968), it was thought that blood platelets might also take up guanethidine. This paper shows that this is the case: guanethidine is concentrated to a considerable degree by an energy-dependent process. As the ratio of the concentration of guanethidine in platelets to that in the incubation medium may exceed 50: 1, the possibility that platelet-bound guanethidine may be of clinical significance is discussed.Some of these experiments have been reported in preliminary communica...