Membrane transporters precisely regulate which molecules cross the plasma membrane and when they can cross. In many cases it is also important to regulate where substances can cross the plasma membrane. Consequently, cells have evolved mechanisms to confine and stabilize membrane transport proteins within specific subdomains of the plasma membrane. A number of different transporters (including ion pumps, channels and exchangers) are known to physically associate with the spectrin cytoskeleton, a submembrane complex of spectrin and ankyrin. These proteins form a protein scaffold that assembles within discrete subdomains of the plasma membrane in polarized cells. Recent genetic studies in humans and model organisms have provided the opportunity to test the hypothesis that the spectrin cytoskeleton has a direct role in restricting transporters to specialized domains. Remarkably, genetic defects in spectrin and ankyrin can produce effects on cell physiology that are comparable to knockouts of the transporters themselves.