Studies have been carried out to investigate aspects of the structure of thrombomodulin, an endothelial cell glycoprotein that binds thrombin and accelerates both the thrombin-dependent activation of protein C and the inhibition of antithrombin III. We have determined the shape of Solulin TM , a soluble recombinant form of human thrombomodulin missing the transmembrane and cytoplasmic domains, by electron microscopy of preparations rotary-shadowed with tungsten. Solulin appears to be an elongated molecule about 20 nm long that has a large nodule at one end and a smaller nodule near the other end from which extends a thin strand. About half of the molecules form bipolar dimers apparently via interactions between these thin strands. Electron microscopy of complexes formed between Solulin and human ␣-thrombin revealed that a single thrombin molecule appears to bind to the smaller nodule of Solulin, suggesting that this region contains the epidermal growth factor-like domains 5 and 6. Epidermal growth factor-like domains 1-4 comprise the connector between the small and large nodule, which is the lectin-like domain; the thin strand at the other end of the molecule is the carbohydrate-rich region. With chondroitin sulfatecontaining soluble thrombomodulin produced from either human melanoma cells Bowes or Chinese hamster ovary cells, a higher percentage of molecules bound thrombin and, in some cases, two thrombin molecules were attached to one soluble thrombomodulin in approximately the same region. These structural studies provide insight into the structure of thrombomodulin and its interactions with thrombin as well as aspects of the mechanisms of its actions.Human thrombomodulin is a single chain glycoprotein made up of 557 amino acids, as well as N-and O-linked carbohydrate, that acts as a co-factor in the activation of protein C by thrombin and a modulator for the specificity of thrombin (1-6). From analysis of the amino acid sequence, thrombomodulin is made up of five regions, a lectin-like domain, a group of six epidermal growth factor-like modules, a serine-, threonine-, and O-glycosylation-rich region, a transmembrane sequence, and a cytoplasmic domain. There is, however, little information on the spatial arrangement of these domains.In its actions as an anticoagulant, thrombomodulin has several functions: the binding of thrombin, resulting in the modulation of its substrate specificity; a co-factor in the activation of protein C; and a co-factor in the inhibition of thrombin by antithrombin III (1, 2, 4 -6). The binding of thrombomodulin to thrombin effectively destroys the specificity of this enzyme for catalyzing the conversion of fibrinogen to fibrin, the activation of factors V, VIII, and XIII, and the activation of platelets. At the same time, in the presence of calcium ions, thrombomodulin acts as a co-factor for the activation of protein C, which, together with protein