The Le(x) (CD15) carbohydrate antigen and sialylated and oligomeric derivatives thereof have been implicated in cell adhesion processes. Expression of these antigens is developmentally regulated and (re)occurrence of several members of this group has been reported in malignant transformation of cells. Studies on the enzymology and genetics of alpha 3-fucosyltransferases, glycosyltransferases that play a key role in the biosynthesis of these antigens, would yield insight in the regulation of expression of these carbohydrate structures. In this paper the existing literature on these enzymes is reviewed and placed in the context of cell adhesion and malignancy.