Subtelomeric deletions are responsible for the loss of expression of several Plasmodium falciparum antigens, including the knob-associated histidine-rich protein (KAHRP). Such deletions are detectable by two-dimensional pulsed-field gradient electrophoresis (PFGE) in which the chromosomes separated in dimension 1 are cleaved with Apa I, and the sizes of telomeric fragments are determined in dimension 2. This sensitive technique has enabled us to examine the role of subtelomeric deletions in two aspects of the biology of Plasmodium falciparum. First, we show that similar subtelomeric deletions to those that occur in vitro also occur in field isolates. Second, we demonstrate a correlation between subtelomeric deletions and loss of the phenotype of "cytoadherence" in cultured isolates. Subclones were generated from the cytoadherent cloned isolate ItG2F6, and their phenotypes were examined with respect to cytoadherence, the expression of "knobs," and agglutination of infected erythrocytes with rabbit antiserum. The only chromosomal change detectable by two-dimensional PFGE among subclones that differ from wild type in each of these three characteristics is a deletion of approximately 100 kilobases at one end of chromosome 2. This deletion includes the gene coding for KAHRP and the subtelomeric repeat designated rep20.Subtelomeric deletions in cultured isolates are known to result in the loss of a number of functional genes of Plasmodium falciparum (1-7). To examine whether this phenomenon occurs in nature or is an artifact of growth in vitro, we used two-dimensional pulsed-field gradient electrophoresis (PFGE) to examine chromosomal DNA from fresh field isolates. This technique allows resolution of telomeric fragments after digestion of separated chromosomes with the restriction endonuclease Apa I. It relies on the observation that a conserved complex consisting of telomeric repeats, an Apa I site(s), and a block of rep20 subtelomeric repeats is common to all chromosomes of P. falciparum (Fig.