The purine phosphoribosyltransferases have emerged as important enzymes in the metabolic economy of the developing human. Hypoxanthine-guanine phosphoribosyltransferase (HGPRT, EC 2.4.2.8) catalyses the conversion of hypoxanthine and guinine into their respective nucleotides. Inherited variation in HGPRT first became evident through clinical observations with the definition of the Lesch-Nyhan syndrome. In this disorder, HGPRT activity in erythrocytes is almost zero, although the fact that sensitive electrophoretic analysis reveals a tiny amount of activity suggests that a protein of altered structure is present. Furthermore, this variant enzyme has been activated by manipulation in the presence of small amounts of normal enzyme. Nevertheless, no cross-reacting material could be detected in lysates of red cells or fibroblasts of patients with the syndrome when tested with antiserum prepared in rabbits to normal erythrocyte HGPRT. We have tested for the presence of cross-reacting material in 18 patients, and all were negative. More HGPRT variants are coming to light. Most of the patients have renal stone disease or gout but no other feature of the Lesch-Nyhan syndrome. In one family four affected males displayed about 5% of normal activity, and the enzyme migrated electrophoretically more rapidly than normal. Cross-reacting material could not be demonstrated in erythrocyte lysates, although it was clear that a variant protein was present. A boy with renal stone disease has been found to have about 1% of normal erythrocyte activity of HGPRT. Cross-reacting material was found in his erythrocytes. The data indicate that mutations which produce diminished enzyme activity in this protein with a distinct subunit structure may or may not so alter the tertiary state of the protein that immunoreactive sites are no longer available to antibody prepared against the normal enzyme. So far whenever a variant normal HGPRT has been found there has been an identifiable clinical illness. The different forms of illness provide for correlation of molecular structure and function in man.