Change in the permeability of the mitochondrial membrane to proteins (cytochrome c and Smac) and protons is a critical step in apoptosis. Although the time from the induction of apoptosis to the change of mitochondrial permeability is variable over a period of hours, the release of proteins is an "all or none" phenomenon that is completed in an individual cell within minutes. Here, using single-cell .uorescence microscopy, we show that the release of cytochrome c from a single mitochondrion occurs in a single step. However, this increased permeability of the outer membrane to cytochrome c propagates throughout the cell as a slower, spatially coordinated wave. The permeability of the outer membrane to Smac propagates with the same spatial pattern but lagging in time. This is followed by a wave of increased permeability of the inner membrane to protons. Only afterward do the mitochondria .ssion. The spatial dependence of the permeability wave was inhibited by thapsigargin, an inhibitor of the endoplasmic reticulum calcium pumps, but buffering cytosolic calcium had no effect. These results show that the trigger for apoptosis is spatially localized, initiating at one or only a few mitochondria preceding the loss of mitochondrial energetics, and the subsequent temporal propagation of mitochondrial membrane permeability is calcium-dependent. © 2009 by the Biophysical Society.