Soluble oligomers and protofibrils of the Aβ42 peptide are neurotoxic intermediates in the conversion of monomeric Aβ42 into the amyloid fibrils associated with Alzheimer's disease. Nuclear magnetic resonance and Fourier transform infrared spectroscopy, along with single-touch atomic force microscopy, are used to establish the structural transitions involved in fibril formation. We show that under conditions favorable for the nucleated conformation conversion, the Aβ42 peptide aggregates into largely unstructured low-molecular weight (MW) oligomers that are able to stack to form high-MW oligomers and to laterally associate to form protofibrils. β-Sheet secondary structure develops during the irreversible lateral association of the oligomers. The first step in this conversion is the formation of an antiparallel β-hairpin stabilized by intramonomer hydrogen bonding. The antiparallel β-hairpins then associate into a cross β-sheet structure with parallel and in-register β-strands having intermonomer hydrogen bonding.