Background: SAMHD1 is a deoxyribonucleoside triphosphate (dNTP) triphosphohydrolase. Results: SAMHD1 forms a catalytically active tetramer upon binding of two nucleoside triphosphates with different specificities at two adjacent allosteric sites. Conclusion: The primary allosteric site selectively binds guanine-containing nucleotides, whereas the secondary site accommodates any dNTP. Significance: The tetramerization and catalytic activity of SAMHD1 is differentially regulated by different nucleoside triphosphates.