Abstract Background SCN5A encodes the cardiac sodium channel a-subunit Nav1.5 with an essential role in generation and conduction of cardiac action potential. Mutations in SCN5A cause Brugada syndrome (BrS) and long QT syndrome (LQTS). The function of Nav1.5, including its cell membrane trafficking and clustering in caveolae, is regulated by MOG1. We recently showed that gene therapy with AAV9-MOG1 reversed disease phenotypes of BrS, dilated cardiomyopathy, cardiac conduction disease and sick sinus syndrome associated with SCN5A mutations. MOG1 is a small chaperon that interacts with multiple sites of Nav1.5, including intracellular Loop I between transmembrane domain I and II and Loop II between domain II and III. We previously characterized the interaction between MOG1 and the intracellular Loop I of Nav1.5, and defined amino acids D24, E36, D44, E53, and E101A of MOG1 as critical residues for its interaction with Nav1.5 Loop I. However, the mechanistic understanding of the interaction between MOG1 and intracellular Loop II of Nav1.5 is needed. Purpose The aim of this study is to perform systematic mutational and electrophysiological studies to identify the key structural elements involved in the interaction between MOG1 and Nav1.5 Loop II and determine the significance of this interaction to the pathogenesis of BrS. Methods Patch-clamping was used to record sodium currents. Glutathione S-transferase (GST) pull-down were used to characterize protein-protein interactions. Results Nav1.5 Loop II contains 765 amino acids, and the domain between amino acids 1157 and 1200 was shown to be the interaction domain for MOG1. Six serial deletions were created, including LoopII△940-982, LoopII△983-1025, LoopII△1026-1068, LoopII△1069-1112, LoopII△1113-1156, and LoopII△1157-1200. GST-pull-down showed that only LoopII△1157-1200 failed to interact with MOG1. MOG1 enhanced sodium current densities all Nav1.5 deletion mutants except for LoopII△1157-1200. Further deletions by every 10-11 amino acids defined the MOG1-interacting domain to 1190-1200. Point mutation analysis defined the MOG1-Nav1.5 Loop II interaction domain to an 8-amino-acid domain of R1193-Y1200 of Nav1.5 Loop II. Mutations R1193W, L1194M and Y1199S associated with BrS reduced the interaction between MOG1 and Nav1.5. MOG1 enhanced sodium current densities from wild type Nav1.5, but not from mutant Nav1.5 with mutations R1193W, L1194M and Y1199S. Conclusions This study identifies the critical elements of Nav1.5 Loop II for interaction with MOG1, and reveals the molecular mechanism by which Nav1.5 mutations R1193W, L1194M and Y1199S cause BrS. Mutations R1193W, L1194M and Y1199S weaken the interaction between Nav1.5 and MOG1, and reduce MOG1-enhanced cardiac sodium current densities.