This investigation was initiated to characterize the stimulation of insulin secretion by phenazine methosulfate (PMS). Islets of Langerhans, isolated by the collagenase method from normal rats and rats pre-injected with either streptozotocin or 6-aminonicotinamide, were exposed to PMS under various experimental conditions and insulin secretion in response to PMS, glucose and pyridine nucleotides was determined. Insulin releasing action of PMS was dose-, time- and temperature-related, occurred in the absence of glucose, and was inhibited by epinephrine, but not by mannoheptulose. In the perifusion system, the pattern of response induced by PMS was spike-like release reaching a maximum in 5 min and declining rapidly to half-maximal value in 10 min. After exposure of islets to beta-cytotoxin either in vivo or in vitro, complete reversal of the cytotoxic effect was obtained with PMS which induced release of insulin in both normal and beta-cytotoxin islets pre-treated. It is concluded that islets depleted of coenzymes could still secrete insulin in response to a reactive proton donor, which might act by substituting for coenzymes and that the immediate action of beta-cytotoxins does not completely arrest the secretory mechanisms in islets of Langerhans.