Lidocaine is a local anesthetic possessing both lipophilic and hydrophilic properties. It also acts as a surfactant. Thus, the disruption of membranes, resulting in necrosis, is one of possible mechanisms for lidocaine-induced cytotoxicity. However, lidocaine is reported to induce apoptosis. Therefore, in order to compare two mechanisms for cell death induced by lidocaine, the effects of millimolar lidocaine were examined on rat thymocytes by a flow cytometer with appropriate fluorescent probes. Lidocaine decreased the population of living cells with phosphatidylserine-exposed membranes, one of markers for early stage of apoptosis, and increased the population of dead cells without increasing that of cells with hypodiploidal DNA. Lidocaine at millimolar concentrations may deteriorate the membranes of such apoptotic living cells rather than those of intact living cells, resulting in necrosis. It is suggested that the process of apoptosis is not completed in the presence of millimolar lidocaine.