Retinitis pigmentosa comprises a group of inherited retinal photoreceptor degenerations that lead to progressive loss of vision. Although in most cases rods, but not cones, harbor the deleterious gene mutations, cones do die in this disease, usually after the main phase of rod cell loss. Rod photoreceptor death is characterized by apoptotic features. In contrast, the mechanisms and features of subsequent nonautonomous cone cell death remain largely unknown. In this study, we show that receptor-interacting protein (RIP) kinase mediates necrotic cone cell death in rd10 mice, a mouse model of retinitis pigmentosa caused by a mutation in a rod-specific gene. The expression of RIP3, a key regulator of programmed necrosis, was elevated in rd10 mouse retinas in the phase of cone but not rod degeneration. Although rd10 mice lacking Rip3 developed comparable rod degeneration to control rd10 mice, they displayed a significant preservation of cone cells. Ultrastructural analysis of rd10 mouse retinas revealed that a substantial fraction of dying cones exhibited necrotic morphology, which was rescued by Rip3 deficiency. Additionally, pharmacologic treatment with a RIP kinase inhibitor attenuated histological and functional deficits of cones in rd10 mice. Thus, necrotic mechanisms involving RIP kinase are crucial in cone cell death in inherited retinal degeneration, suggesting the RIP kinase pathway as a potential target to protect cone-mediated central and peripheral vision loss in patients with retinitis pigementosa.R etinitis pigmentosa (RP) refers to a group of inherited retinal degenerations that affect over one million individuals globally (1). Although vitamin A supplementation and an Ï-3 rich diet has been shown to slow down the visual decline in some patients (2), they do not stop the disease progression and irreversible vision loss still ensues for many patients. Vision loss in RP results from photoreceptor cell death and typically begins with loss of night vision (because of rod dysfunction and death), followed by loss of peripheral and central vision because of loss of cones. This cone-mediated dysfunction is the most debilitating aspect of the disease for patients. Molecular genetic studies have identified mutations in more than 50 genes, most expressed exclusively in rod photoreceptors, which are associated with RP. Although rods that harbor the deleterious gene mutations are expected to die, it is still a puzzle why and how cones-that do not harbor deleterious gene mutations-do die subsequent to the rod degeneration phase.Apoptosis and necrosis are two distinct modes of cell death defined by morphological appearance (3). Apoptosis is the bestcharacterized type of programmed cell death, and the caspase family proteases play a central role in the induction of this process (4). Necrosis, which was traditionally thought to be an uncontrolled process of cell death, is now known to also have a regulated component in some instances (5, 6). Two members of the receptor-interacting protein (RIP) kinase family proteins, ...