The inhibitor of apoptosis protein survivin is a bifunctional molecule which regulates cellular division and survival. We have previously shown that survivin protein can be found at high concentrations in the adult kidney, particularly in the proximal tubules. Here, survivin is localized primarily at the apical membrane, a pattern which may indicate absorption of the protein. Several proteins in primary urine are internalised by megalin, an endocytosis receptor, which is in principle found in the same localization as survivin. Immunolabeling for survivin in different species confirmed survivin signal localising to the apical membrane of the proximal tubule. Immuno-electron microscopy also showed apical localisation of survivin in human kidneys. Furthermore, in polarised human primary tubular cells endogenous as well as external recombinant survivin stored in the apical region of the cells. Co-staining of survivin and megalin by immunohistochemistry and immuno-electron microscopy confirmed colocalization. Finally, by surface plasmon resonance we were able to demonstrate that survivin binds megalin and cubilin and that megalin knockout mice loose survivin through the urine. Survivin accumulates at the apical membrane of the renal tubule by reuptake, which is achieved by the endocytic receptor megalin, collaborating with cubilin. For this to occur, survivin will have to circulate in blood and be filtered into the primary urine. It is not known at this stage what the functional role of tubular survivin is. However, a small number of experimental and clinical reports implicate that renal survivin is important for functional integrity of the kidney.