P-glycoprotein (P-gp, ATP-binding cassette B1) is a drug pump that extracts toxic drug substrates from the plasma membrane and catalyzes their ATP-dependent efflux. To map the residues in the drug translocation pathway, we performed arginine-scanning mutagenesis on all transmembrane (TM) segments (total ؍ 237 residues) of a P-gp processing mutant (G251V) defective in folding (15% maturation efficiency) (glycosylation state used to monitor folding). The rationale was that arginines introduced into the drug-binding sites would mimic drug rescue and enhance maturation of wild-type or processing mutants of P-gp. It was found that 38 of the 89 mutants that matured had enhanced maturation. Enhancer mutations were found in 11 of the 12 TM segments with the largest number found in TMs 6 and 12 (seven in each), TMs that are critical for P-gp-drug substrate interactions. Modeling of the TM segments showed that the enhancer arginines were found on the hydrophilic face, whereas inhibitory arginines were located on a hydrophobic face that may be in contact with the lipid bilayer. It was found that many of the enhancer arginines caused large alterations in P-gp-drug interactions in ATPase assays. For example, mutants A302R (TM5), L339R (TM6), G872R (TM10), F942R (TM11), Q946R (TM11), V982R (TM12), and S993R (TM12) reduced the apparent affinity for verapamil by ϳ10-fold, whereas the F336R (TM6) and M986R (TM12) mutations caused at least a 10-fold increase in apparent affinity for rhodamine B. The results suggest that P-gp contains a large aqueousfilled drug translocation pathway with multiple drug-binding sites that can accommodate the bulky arginine side chains to promote folding of the protein.The human multidrug resistance P-glycoprotein (P-gp, ATP-binding cassette B1)2 is an ATP-dependent drug pump that mediates efflux of a broad range of hydrophobic compounds out of the cell (1). It is expressed in the epithelium of liver, kidney, and gastrointestinal tract and at the blood-brain or blood-testes barrier where it functions to protect us from cytotoxic compounds. It is clinically important because it contributes to multidrug resistance in diseases such as cancer and AIDS (1).P-gp is an ATP-binding cassette transporter of 1280 amino acids that consists of two homologous halves (2). Each half begins with a transmembrane domain (TMD) containing six TM segments followed by a nucleotide-binding domain (NBD).A key goal to understanding the mechanism of P-gp drug transport is to identify the amino acids that line the drug translocation pathway. Because P-gp extracts drug substrates from the lipid bilayer, the drug-binding pocket/drug translocation pathway are predicted to reside in the transmembrane (TM) segments. We previously showed that the TMDs alone were sufficient for drug binding (3). Expression of the TMDs as separate polypeptides showed that both TMD1 and TMD2 were required for binding drug substrate (4). The results of studies utilizing cysteine-scanning mutagenesis and labeling with thiol-reactive drug substrates sugg...