The initial and rate-limiting step in prostaglandin biosynthesis is stereoselective removal of the pro-S hydrogen from the 13-carbon of arachidonic acid. This is followed by oxygenation at C-11, formation of the five-membered ring, and a second oxygenation at C-15 to yield the endoperoxide product, prostaglandin G(2). Aspirin treatment of cyclooxygenase-2 is known to acetylate an active site serine, block prostaglandin biosynthesis, and give 15R-hydroxyeicosatetraenoic acid (15R-HETE) as the only product. 15R-HETE and prostaglandins have opposite stereoconfigurations of the 15-hydroxyl. To understand the changes that lead to 15R-HETE synthesis in aspirin-treated COX-2, we employed pro-R- and pro-S-labeled [13-(3)H]arachidonic acids to investigate the selectivity of the initial hydrogen abstraction. Remarkably, aspirin-treated COX-2 formed 15R-HETE with removal of the pro-S hydrogen at C-13 (3-9% retention of pro-S tritium label), the same stereoselectivity as in the formation of prostaglandins by native cyclooxygenase. To account for this result and the change in oxygenase specificity, we suggest that the bulky serine acetyl group forces a realignment of the omega end of the arachidonic acid carbon chain. This can rationalize abstraction of the C-13 pro-S hydrogen, the blocking of prostaglandin synthesis, and the formation of 15R-HETE as the sole enzymatic product.