Sterol 14␣-demethylase (CYP51), a major checkpoint in membrane sterol biosynthesis, is a key target for fungal antibiotic therapy. We sought small organic molecules for lead candidate CYP51 inhibitors. The changes in CYP51 spectral properties following ligand binding make CYP51 a convenient target for highthroughput screening technologies. These changes are characteristic of either substrate binding (type I) or inhibitor binding (type II) in the active site. We screened a library of 20,000 organic molecules against Mycobacterium tuberculosis CYP51 (CYP51 Mt ), examined the top type I and type II binding hits for their inhibitory effects on M. tuberculosis in broth culture, and analyzed them spectrally for their ability to discriminate between CYP51 Mt and two reference M. tuberculosis CYP proteins, CYP130 and CYP125. We determined the binding mode for one of the top type II hits, ␣-ethyl-N-4-pyridinyl-benzeneacetamide (EPBA), by solving the X-ray structure of the CYP51 Mt -EPBA complex to a resolution of 1.53 Å. EPBA binds coordinately to the heme iron in the CYP51 Mt active site through a lone pair of nitrogen electrons and also through hydrogen bonds with residues H259 and Y76, which are invariable in the CYP51 family, and hydrophobic interactions in a phylumand/or substrate-specific cavity of CYP51. We also identified a second compound with structural and binding properties similar to those of EPBA, 2-(benzo[d]-2,1,3-thiadiazole-4-sulfonyl)-2-amino-2-phenyl-N-(pyridinyl-4)-acetamide (BSPPA). The congruence between the geometries of EPBA and BSPPA and the CYP51 binding site singles out EPBA and BSPPA as lead candidate CYP51 inhibitors with optimization potential for efficient discrimination between host and pathogen enzymes.In eukaryotic organisms, cytochrome P450 enzymes play important roles in many systems, including the biosynthesis of cholesterol, steroid hormones, and vitamins; the control of cardiovascular physiology and systemic blood pressure; drug metabolism; and chemical toxicology and carcinogenesis (23). With respect to their potential for pharmacological development, eukaryotic P450 enzymes may be divided into two groups, drug targets and drug-metabolizing enzymes. Wellestablished P450 drug targets include (i) the aromatase CYP19, required for the conversion of androgens into estrogens (30) and a key target in the treatment of breast cancer; (ii) sterol 14␣-demethylases (CYP51), required for the biosynthesis of membrane sterols, including cholesterol in animals, ergosterol in fungi, and a variety of C-24-modified sterols in plants and protozoa (2), and a key target in the treatment of diseases caused by infectious microbes; and (iii) other biosynthetic sterol hydroxylases (20). The isoform-specific inhibition of P450 enzymes offers promise for the development of therapeutic, insecticidal, and herbicidal agents (7). High-throughput screening (HTS) libraries of small organic molecules and potential drugs against P450 enzymes may thus be key to selecting high-quality compounds in the lead identificat...