Previous studies have documented that the barrier function of epithelial or endothelial monolayers is deranged when cellular ATP levels are rapidly decreased to very low levels by inhibitors of mitochondrial and glycolytic function. We hypothesized that lesser degrees of ATP depletion also might affect epithelial permeability, particularly if the perturbation were sustained for a prolonged interval. Using Caco-2BBe cells grown on permeable supports mounted in bicameral chambers, we assessed permeability by measuring the apical-to-basolateral clearance (flux divided by apical compartment concentration) of fluorescein disulfonic acid. ATP was depleted by incubating cells in glucose-free (Glu-) medium containing 10 mM 2-deoxyglucose (2-DOG) for 12, 24, or 48 h or under an anoxic atmosphere for 24, 48, or 72 h. Although both models of energy depletion were characterized by significant derangements in barrier function, metabolic inhibition with 2-DOG/ Glu- resulted in greater increases in permeability and more profound decrements in cellular ATP content. Morphological studies using electron and confocal fluorescence microscopy showed structural changes in individual cells and derangements in the normal distribution of perijunctional actin after monolayers were incubated with 2-DOG/Glu- but not after incubation under an anoxic atmosphere. Addition of 10 mM lactic acid (final pH 6.7) provided significant protection against both hyperpermeability and ATP depletion induced by 2-DOG/Glu-. We conclude that moderate degrees of ATP depletion are sufficient to increase the permeability of Caco-2BBe monolayers and that lactic acidosis helps to preserve ATP content, barrier function, and morphological integrity in hypoxic intestinal epithelial cells.