Human erythrocytes when lysed and resealed to Ca in the presence of dextran can be readily separated from the suspending medium by low-speed centrifugation. 2. Ghosts trapped Ca and EGTA at the same ratio as present in the haemolytic medium and remained tight to Ca after washing and subsequent incubation for up to 90 min at 37 degrees C. 3. Ca extrusion could be promoted by substrates other than ATP only from ghosts that had been loaded with low free Ca concentrations (1--22 microM). The order of activation by the various substrates employed was ATP greater than adenine + inosine greater than inosine. 4. The kinetics of extrusion depended markedly on internal free Ca. The system showed a high affinity state (KCa about 3 microM; V = 0.34 mumol Ca/ml ghosts per min) at low concentrations (1--22 microM) and a low affinity state (KCa about 250 microM; V = 0.17 mumol Ca/ml ghosts per min) at high concentrations (0.2--4.0 mM). 5. Both at low and at high free Ca, La-sensitive ATP hydrolysis was closely correlated with La-dependent Ca efflux, in keeping with an stoichiometry of 1.6. The rate of extrusion was maximal in the presence of 160 mM KCl and decreased to various extents when K was fully replaced by different cations, following the order K greater than Na = choline greater than Mg. 7. The efflux rate of high-K ghosts, resealed to alkaline cations, was stimulated by external Na, whilst Mg and choline was practically without effect. 8. The results indicate that human red cells possess a powerful Ca extrusion mechanism, the activity of which can be modulated by alkaline cations.