Adverse drug reactions (ADRs) are a major clinical problem. A rapidly growing body of evidence suggests that genetic factors, at least in part, determine individual susceptibility to ADRs. A large number of pharmacogenetic studies have identified a number of polymorphisms as predictors of drug efficacy and/or adverse events. These candidate markers should be investigated further to ascertain the underlying mechanism of action, for example, changes in the kinetic parameters of an enzyme, or transcriptional activity of a promoter region. In this chapter, we describe a transient transfection assay for the functional characterization of naturally occurring variants of UDP-glucuronosyltransferase (UGT) 1A1. This phase II drug metabolizing enzyme is involved in the glucuronidation of SN-38, an active metabolite of the anti-cancer drug irinotecan. Single-nucleotide polymorphisms of the UGT1A1 gene have been correlated to irinotecan-induced ADRs. Variant UGT1A1s are heterologously expressed in COS-1 cells and characterized in terms of the level of protein expression and enzyme kinetics.