Abstract: Promising biomedical uses for nonthermal plasma (NTP) in the fields of regenerative medicine, cancer therapy, and vaccine delivery involve the noninvasive application of uniform nonequilibrium plasma (including dielectric barrier discharge plasma) to living skin. Whereas most investigations have focused on achieving desired therapeutic outcomes, fewer studies have examined the mechanisms and pathways by which epithelial cells respond to NTP exposure. Using a transwell apical-basolateral-chambered system to culture the human keratinocyte HaCaT cell line, in vitro experiments were performed to demonstrate the effects of nanosecond-pulsed dielectric barrier discharge (nsDBD) plasma on polarized epithelial cell viability, monolayer permeability, intracellular oxidative stress, and the release of adenosine triphosphate (ATP). Application of nsDBD plasma at 60 Hz or below had minimal or no effect on HaCaT monolayer viability or permeability. nsDBD plasma exposure did, however, result in frequency-dependent reductions in intracellular glutathione (indicating direct induction of oxidative stress by nsDBD plasma) and increased extracellular ATP concentrations in the ba-solateral (subepithelial) media, which are indicators of cellular stress and an NTP-induced inflammatory response. These studies provide new insights into nsDBD plasma-induced inflammation and local innate immune responses initiated by polarized epithelial tissues.