The transfer and metabolism of L-carnitine. L-acetylcarnitine, and L-palmitoylcarnitine were studied in the human placenta at term by means ofin vitrodual perfusion of a placental lobe. L-Carnitine transfer was 20% that of the freely diffusing antipyrine and 40% that of L-lysine. The transfer of L-acetylcarnitine was similar to that of L-carnitine, but no placental transfer of L-palmitoylcarnitine was found. In contrast to L-lysine, L-carnitine, and L-acetylcarnitine were not actively transported from the maternal to the fetal circulation. No stereospecific transfer of carnitine across the placenta was found. However, there was stereospecific uptake of carnitine by placental tissue. The placenta exhibited an active carnitine metabolism by esterifying free carnitine and hydrolyzing carnitine esters taken up from the perfusion medium and releasing the metabolites into the fetal and maternal circulations.