A newly developed technique for estimating the number of motor units in the biceps-brachialis muscles and for studying the innervation patterns of motor units in the same muscles has been applied to the study of 17 patients with amyotrophic lateral sclerosis (ALS). Although severe motor unit losses were seen in many ALS cases, in most there were clear indications of increases in innervation densities, linked potentials, and blocking. This technique provides a powerful new tool for quantitatively assessing the extent of motor unit losses and the accompanying changes in innervation patterns in ALS.