The Alzheimer's disease amyloid precursor protein is sequentially processed to yield the neurotoxic amyloid-beta (A beta) peptide, which is the principal component of the senile plaques in Alzheimer's disease brains. This review will outline the current thinking on how A beta mediates neurotoxicity or neuronal dysfunction. In particular, this article will focus on the key residues that modulate A beta's activity and the cellular pathways and mechanisms involved. It will detail how A beta-metal interactions are a key determinate in Alzheimer's disease pathogenesis.