A sensitive luminol-dependent chemiluminescence assay for H2O2 was developed for the indirect determination of the transient changes in NADPH oxidase activity associated with the respiratory burst of human neutrophils. A relatively large, controlled amount of horseradish peroxidase was used in combination with added luminol to rapidly remove and simultaneously detect H2O2 as soon as it is formed, thus preventing its accumulation during burst activity and minimizing the effects of side reactions. Cell-derived myeloperoxidase and possibly catalase were inhibited with 90 microM sodium azide to maintain the total catalytic activity toward H2O2 at a constant level. Chemiluminescence measurements of the respiratory burst activity of human neutrophils stimulated with N-formyl-Met-Leu-Phe (fMLP) were in good agreement with measurements made using an established fluorometric assay based on similar principles (P. A. Hyslop and L. A. Sklar (1984) Anal. Biochem. 141, 280-286). In contrast to fluorometry, the chemiluminescence progress curves reflect the instantaneous rather than the integrated levels of H2O2 at any time and are thus a more direct measure of the activity of the NADPH oxidase. This advantage, as well as higher signal-to-noise ratios and greater inherent sensitivity, distinguishes chemiluminescence as a means of following burst activity. The onset of fMLP-stimulated H2O2 generation was detectable by chemiluminescence within 2 s of stimulation (as opposed to more than double this time by fluorometry), showing that high sensitivity is an important consideration in evaluating respiratory burst kinetics. In contrast to fMLP stimulation, longer and concentration-dependent onset times were observed when phorbol myristate acetate was used as a stimulus.