Macroautophagy has been implicated as a mechanism of cell death. However, the relationship between this degradative pathway and cell death is unclear as macroautophagy has been shown recently to protect against apoptosis. To better define the interplay between these two critical cellular processes, we determined whether inhibition of macroautophagy could have both pro-apoptotic and anti-apoptotic effects in the same cell. Embryonic fibroblasts from mice with a knock-out of the essential macroautophagy gene atg5 were treated with activators of the extrinsic and intrinsic death pathways. Loss of macroautophagy sensitized these cells to caspase-dependent apoptosis from the death receptor ligands Fas and tumor necrosis factor-␣ (TNF-␣). Atg5 ؊/؊ mouse embryonic fibroblasts had increased activation of the mitochondrial death pathway in response to Fas/TNF-␣ in concert with decreased ATP levels. Fas/TNF-␣ treatment failed to up-regulate macroautophagy, and in fact, decreased activity at late time points. In contrast to their sensitization to Fas/TNF-␣, Atg5؊/؊ cells were resistant to death from menadione and UV light. In the absence of macroautophagy, an up-regulation of chaperone-mediated autophagy induced resistance to these stressors. These results demonstrate that inhibition of macroautophagy can promote or prevent apoptosis in the same cell and that the response is governed by the nature of the death stimulus and compensatory changes in other forms of autophagy. Experimental findings that an inhibition of macroautophagy blocks apoptosis do not prove that autophagy mediates cell death as this effect may result from the protective up-regulation of other autophagic pathways such as chaperonemediated autophagy.The relationship between the cellular processes of macroautophagy, quantitatively the most important form of autophagy in mammalian cells, and cell death remains unclear (1). Experimental evidence from several model systems suggests that autophagy is a mechanism of cell death. These findings have led to the concept that programmed cell death can result from one of two distinct pathways, apoptosis or autophagy (2). These two forms of cell death can be distinguished by their morphological differences. Apoptosis is marked by cytoskeletal collapse that leads to cellular condensation and caspase-dependent DNA fragmentation but the relative preservation of organelles. In contrast, the critical initiating feature of autophagic cell death is not cytoskeletal breakdown but organelle degradation. Macroautophagy has been implicated as a mechanism of cell death from a variety of factors including radiation, tumor necrosis factor-␣ (TNF-␣), 3 viruses, and low potassium (3-6). This conclusion is supported by two findings: 1) the presence of increased numbers of autophagosomes in cells responding to these death stimuli, indicative of an up-regulation of macroautophagy that may kill the cell; and 2) the prevention of cell death by inhibition of macroautophagy with 3-methyladenine (3-MA) or RNA interference against autophagy-re...