Recent findings suggest a pathologic role of skeletal muscle in amyotrophic lateral sclerosis (ALS) onset and progression. However, the exact mechanism by which this occurs remains elusive due to limited human-based studies. To this end, phenotypic ALS skeletal muscle models were developed from induced pluripotent stem cells (iPSCs) derived from healthy individuals (WT) and ALS patients harboring mutations in the superoxide dismutase 1 (SOD1) gene. Although proliferative, SOD1 myoblasts demonstrated delayed and reduced fusion efficiency compared to WT. Additionally, SOD1 myotubes exhibited significantly reduced length and cross-section. Also, SOD1 myotubes had loosely arranged myosin heavy chain and reduced acetylcholine receptor expression per immunocytochemical analysis. Functional analysis indicated considerably reduced contractile force and synchrony in SOD1 myotubes. Mitochondrial assessment indicated reduced inner mitochondrial membrane potential (ΔΨm) and metabolic plasticity in the SOD1-iPSC derived myotubes. This work presents the first wellcharacterized in vitro iPSC-derived muscle model that demonstrates SOD1 toxicity effects on human muscle regeneration, contractility and metabolic function in ALS. Current findings align with previous ALS patient biopsy studies and suggest an active contribution of skeletal muscle in NMJ dysfunction. Further, the results validate this model as a human-relevant platform for ALS research and drug discovery studies. Amyotrophic lateral sclerosis (ALS) is an aggressive, multi-factorial disease characterized by progressive motoneuron degeneration, muscle weakness and wasting 1. It typically manifests between ages 40 and 70 and results in death within 2-5 years of diagnosis. Ten percent of all reported ALS cases are familial (fALS) while the remaining are sporadic (sALS). Currently, genetic mutations in over twenty genes including superoxide dismutase 1 (SOD1), chromosome 9 open reading frame 72 (C9orf72), fused in sarcoma (FUS), and TAR DNA binding protein 43 (TDP43) are associated with ALS 2. However, the pathogenesis of ALS remains largely unknown. It is understood that disruption of the neuromuscular junction (NMJ) is an early event in ALS pathology 3-6 , however, the mechanisms that lead to NMJ dysfunction are still unresolved. Specifically, there is disagreement in the literature regarding whether motoneuron (MN) dysfunction causes neuromuscular denervation, or skeletal muscle dysfunction drives synaptic degradation, thereby causes retrograde MN dysfunction and death 3,7,8. The specific susceptibility of MNs in ALS led early researchers to adopt a "neurocentric" approach to investigating the disease 9,10. However, mounting evidence suggests the involvement of the skeletal muscle in ALS onset via NMJ disruption 11-13. Fischer and colleagues published evidence of disrupted NMJs without signs of MN death in a spatiotemporal study performed in ALS murine models 5,6,12. In the same report, they presented pathology results from an ALS patient that demonstrated skeletal musc...