Synaptic and ultrastructural organization in the intermediolateral nucleus (IML) of rat were investigated with electron microscopy combined with pre-embedding immunohistochemistry for substance P (SP)-receptor (SPr). SPr immunoreactivity in IML was found in the vicinity of the cellular membrane of the perikarya and dendritic profiles of the small sized neurons, ranging from 15 to 25 microns in length. A SPr-immunoreactive (SPr-ir) soma had symmetric or asymmetric synaptic contacts with three to five unlabeled axon terminals. Two different types of axon terminals made synapses on the SPr soma, one contained 20-30 nm pleomorphic vesicles and large dense cored vesicles and the other contained clear pleomorphic vesicles of 30-50 nm in size. Occasionally, SPr-ir dendrites are very closely apposed to the blood capillary. Our present results suggested the possibility that the IML SPr-ir neurons might be activated by several kinds of synaptic inputs and SP provided from blood flow.