Staphylococcal superantigens (SEs and TSST-1) interact with and potentially activate two of the main subsets of the immune system: T lymphocytes and MHC class II-positive cells. Since the interaction of SEs and TSST-1 with MHC class II molecules is the first step in triggering immune cells activation, a detailed understanding of the nature of this interaction is essential for understanding its effect on the immune system and for designing therapeutic strategies for SEs and TSST-1-mediated injury. A series of events is induced in MHC class II-positive cells (B cells, activated T cells, monocytes, and synoviocytes) upon engagement with superantigens. Some of these events require monomeric forms of superantigens, whereas others are critically dependent on cross-linking of toxin-bound MHC class II molecules by a biochemical agent (biotin-avidin) or a natural physiological one such as the TCR. The ability of superantigens to induce polyclonal activation of MHC class II-positive cells may confer to the superantigen its capacity to trigger autoimmune diseases.