Immunocytochemical examinations of the brains of patients with senile dementia of the Alzheimer type, Down's syndrome, and Gerstmann-Sträusslar-Scheinker disease were performed to clarify the relationship between alpha 1-antichymotrypsin and senile plaque amyloids. Alpha 1-antichymotrypsinlike immunoreactivity was enhanced by protease digestion but not by formic acid pretreatment. Almost all of the diffuse plaques and some small amyloid deposits, which were widely distributed in the cerebral cortex and/or subcortical regions of SDAT brains, were labeled by alpha 1-antichymotrypsin immunostaining. All types of senile plaques, eosinophilic tangles, and some neurons and astrocytes were labeled by alpha 1-antichymotrypsin staining. Diffuse plaques in a Down's syndrome frontal lobe and in a senile dementia of the Alzheimer type cerebellum also were labeled by alpha 1-antichymotrypsin immunostaining. However neither subpial amyloid deposits nor subcortical small amyloid deposits could be detected by alpha 1-antichymotrypsin immunostaining. Kuru plaques in a Gerstmann-Sträusslar-Scheinker disease cerebellum also were not labeled by alpha 1-antichymotrypsin immunostaining. These results suggest that alpha 1-antichymotrypsin is associated with the early to late stages of amyloid deposition and senile plaque formation in senile demential of the Alzheimer type.