Diphtheria toxin can be used to selectively kill target cells by coupling it to cell-type-specific binding moieties such as monoclonal antibodies. These reagents have important potential in treating diseases, selectively ablating cell populations in experimental systems and for understanding how proteins cross membranes. Point mutations and deletions in the diphtheria toxin gene have been used to identify and localize regions of diphtheria toxin involved in cell killing. Mutations have been identified that prevent binding of the toxin to a cell surface receptor yet these mutations do not inhibit the cell entry activity or the intracellular cytotoxicity of the toxin. Coupling of these mutant toxins to new, cell-type-specific binding moieties yields potent reagents with up to 200,000-fold selectivity between target and nontarget cells. Mutations and deletions in the membrane transport regions are beginning to explain how the toxin enters cells and may also help in the design of more effective therapeutic reagents.