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In certain epithelial tissues, water permeability is markedly increased by antidiuretic hormone. This so-called hydrosmotic effect has been shown to be mediated by 3'-5' cyclic adenosine monophosphate, which, in turn, alters the permeability o the luminal membrane of receptor cells. This review deals wity ultrastructural alterations occurring in the membrane, as observed with freeze-fracture electron microscopy. Basically, these alterations consist of organized particle aggregates which appear in the apical membrane. In all experimental conditions, similar aggregates can be observed in the membrane of cytoplasmic vesicles. ADH stimulation triggers the fusion of these vesicles with the apical membrane resulting in the concomitant transfer of particle aggregates. It has been shown, in a wide range of experimental conditions, that both number and total area of the aggregates are directly proportional to the water permeability of the tissue. It is generally assumed that particle aggregates contain transmembrane channels that are selectively to water.