SUMMARY The diagnostic and prognostic significance of the different types of serum smooth muscle antibodies (SMA) were investigated in sera of 24 patients with chronic active hepatitis (CAH) and 15 patients with primary biliary cirrhosis (PBC). SMA of IgG class were found in 92 % of sera from patients with CAH but in only 20 % of sera from PBC patients, whereas the incidence of IgM-SMA was higher in PBC (67 %) than in CAH (38 %). All six patients with the atypical cholestatic form of CAH had SMA of IgM class, whereas other CAH patients had SMA of mainly IgG class. SMA reacting with rabbit liver (bile canaliculus antibodies, BCA) and with rat glomeruli (glomerulus antibodies) were of anti-actin specificity and were more common in CAH than in PBC. Organ specific BCA or glomerulus antibodies were not found. Anti-actin antibodies were detected in the majority of the investigated sera by an immunoenzymatic anti-actin assay. The results suggest that the determination of SMA titres with heavy chain specific antisera may help in the assessment of diagnosis and prognosis of chronic hepatitis.Chronic active hepatitis (CAH) and primary biliary cirrhosis (PBC) are characterised by the presence of high titres of non-organ specific autoantibodies; mitochondrial antibodies (AMA) in PBC and antinuclear antibodies (ANA) and smooth muscle antibodies (SMA) in CAH. These autoantibodies have differential diagnostic importance1 but this is disturbed by the considerable overlap between the serological findings in CAH and PBC. AMA occur in 83-100% of cases with PBC and in 11-35% of cases with CAH. SMA are found in 61-86% of patients with CAH and in 32-49% of patients with PBC.2-8 Antinuclear antibodies are frequently found in both diseases. Some authors have described glomerulus antibodiesg and bile canaliculus antibodies10 11 in CAH and PBC, and a relationship to SMA has been proposed.12-'4The determination of different types of AMA may have diagnostic significance.1' There are also several types of smooth muscle antibodies.'6 17 SMA in