Cell-surface oligosaccharides can function as ligands for intercellular adhesion receptors, matrix proteins, and growth factors. We report that human neonatal and adult epidermal keratinocytes (KC) express sialyl Lewis X [s-Le(x); SAalpha2-3Galbeta1-4(Fucalpha1-3)GlcNAcbeta1-3R], a ligand for endothelial and platelet selectins. Freshly isolated or cultured KC bind FH6 monoclonal antibody (MoAb), which is specific for s-Le(x)-containing oligosaccharides. The relevant epitope is bona fide s-Le(x), because sialidase treatment of KC suspensions abrogates FH6 binding while generating de novo KC reactivity with anti-Le(x). KC stained in ice-cold suspension display a knobby membrane. distribution of s-Le(x) detectable by immunofluorescence microscopy. As others have reported, FH6 appeared not to bind KC in perpendicular skin sections. However, basal KC in intact epidermal sheets exhibited obvious "honeycomb" reactivity with FH6 when stained and viewed en face, suggesting that s-Le(x) in intact epidermis may occur in bands that parallel the major tissue axis. FH6 specifically immunoprecipitated proteins of Mr 34 kd, 44 kd, and 56 kd from [S-35]-labeled KC and anti-Le(x) precipitated similar proteins from sialidase-treated KC. The enzymatic basis for KC s-Le(x) expression was studied by analyzing acceptor specificities and other properties of KC fucosyltransferases. Results indicate that KC express both Lewis- and myeloid-type alpha1-3fucosyltransferases. KC s-Le(x) could be an important element of the epithelial milieu, because both epithelial cells and immune cells that home to epithelia express s-Le(x) and related structures, and because KC s-Le(x) is well positioned for selectin-mediated platelet binding after transcutaneous wounding. The apparent distributions of s-Le(x) in epidermis and on isolated KC are compatible with a functional role for s-Le(x) in these intercellular interactions.