The synthesis, segregation, intracellular transport, and exocytic export of secretory proteins in eukaryotic cells is now well understood. Synthesis begins on free cytosolic ribosomes that subsequently attach to the ER, resulting in the cotranslational discharge of the nascent proteins into the ER lumen. The targeting signals and the cytosolic and ER membrane components that mediate the translocation step have been extensively characterized and reviewed (for example, see 29). The ER lumen contains a range of resident proteins responsible for modifying newly synthesized polypeptides, and for ensuring correct folding into the biologically active conformation (9). Secretion entails transport of the proteins from the ER, via the Golgi stack and the TGN, to secretory vesicles that ultimately fuse with the plasma membrane to complete protein export. The secretory pathway was elucidated by Palade and his colleagues (24). Protein transport between the various compartments of the secretory pathway is mediated by carrier vesicles that bud from one compartment and fuse with the next. Once again, many of the cellular components that are required for, and that regulate, vesicular transport have been identified, and the mechanisms by which cytoplasmic protein coats drive the individual transport steps are now emerging (31). It has been recognized for some time that the secretory pathway is at least partially reversible. For example, retrograde vesicular transport from the Golgi to the ER is needed to retrieve resident ER proteins that have escaped from this compartment (25), and endocytosis can transport proteins from the cell surface to the TGN (2), which is the cellular location where the secretory and endocytic pathways converge (31). ER resident proteins contain a retrieval signal, the COOH-terminal tetrapeptide Lys-Asp-Glu-Leu (KDEL),1 which binds to a membrane receptor in the cis-Golgi region and returns them to the ER. Indeed the KDEL receptor is capable of retrieving escaped ER resident proteins from as far along the secretory pathway as the TGN; an exogenous synthetic peptide with a COOH-terminal KDEL sequence, which was introduced into the TGN from the cell surface was subsequently transported to the ER lumen (20). Recently, it has become apparent that certain protein toxins follow this same route from the surface to the ER lumen. To reach their targets in the cytosol of mammalian cells the toxins apparently go one step further and cross the ER membrane. The emerging experimental evidence in support of this is reviewed here.