Human peripheral blood monocytes from normal donors were isolated by elutriation and differentiated by culture in the presence or absence of various immunomodulators. Cells were harvested between 0 and 24 days and tested for their ability to kill schistosomula of Schistosoma mansoni in vitro as a measure of activation. Freshly isolated monocytes showed no significant cytotoxic activity in the presence or absence of IFN-gamma or LPS. As the cells matured in vitro, there was a slight increase in their inherent toxicity against the parasite, which was greatly enhanced by pretreatment with either IFN-gamma or CSF-1. Optimal antibody-independent larvicidal activity occurred after stimulation with both IFN-gamma and CSF-1, using cells that had matured for at least 7 days in vitro. Under these conditions, killing of up to 70% of the larvae was observed. Although enhanced larvicidal activity was not found to strictly correlate with production of any of several proposed effector molecules examined, activated monocyte-derived macrophages were capable of producing significant amounts of H2O2 and TNF-alpha. These observations indicate that cytokine-activated human monocyte-derived macrophages are able to kill schistosome larvae by an antibody-independent mechanism, as has been observed using murine peritoneal macrophages. Stimulation with multiple differentiation and activation signals, as would occur in vivo, may be required for development of optimal larvicidal activity.