We studied the antibody response to various kinds of well-characterized synthetic peptides of human T lymphotropic virus type 1 (HTLV-1) envelope glycoproteins in patients with HTLV-1 associated myelopathy (HAM)/tropical spastic paraparesis (TSP) and non-HAM/TSP HTLV-1 carriers. The serum antibody titers to most of the synthetic peptides were significantly higher in patients with HAM/TSP than those in non-HAM/TSP HTLV-1 carriers. However, the degree of the increase of antibody titers to the synthetic peptides corresponding to the transmembrane portions of HTLV-1 envelope glycoproteins (env-p20E), such as p20E 332-352, 374-392, 426-448 and 458-488, was greater than those to synthetic peptides of exterior portions of HTLV-1 envelope glycoproteins (env-gp46) in sera from patients with HAM/TSP. Antibodies to env-p20E 332-352 and 374-392 were elevated in the cerebrospinal fluid (CSF) only from patients with HAM/TSP but not from non-HAM/TSP HTLV-1 carriers. These data indicate that the increase of antibody titers to transmembrane portions of HTLV-1 envelope glycoproteins in sera and CSF is a characteristic feature of antibody response in patients with HAM/TSP and may be closely associated with the development of HAM/TSP from non-HAM/TSP HTLV-1 carriers.