The final step in the action of antidiuretic hormone (ADH) is the insertion of aggregates of water-conducting particles into the luminal membrane of the receptor cell. The aggregates arise from cytoplasmic tubular structures that fuse with the luminal membrane. This review presents a number of questions about this process, along with current attempts to answer them. The following topics are addressed: 1) the exact role of the cytoskeleton in promoting tubular fusion, 2) the nature of the translocation process leading to fusion, 3) the point in the sequence at which ADH enters, 4) the composition and structure of the water-conducting particles. Some of the answers require a more complete understanding of the structure of the apical portion of ADH-sensitive cells; recent morphological studies are therefore included.