Neuraminidase is a surface glycoprotein of influenza viruses that cleaves terminal sialic acids from carbohydrates. It is critical for viral release from infected cells and facilitates viral spread in the respiratory tract. The catalytic active site of neuraminidase is highly conserved in all type A and B influenza viruses, making it an excellent target for antiinfluenza drug design. Indeed, neuraminidase inhibitors have recently become available in the clinic for the treatment of influenza. Here, we describe the use of 3D structures of neuraminidase-inhibitor complexes to derive quantitative structure-activity relationships (QSARs) to aid understanding of the mechanism of inhibition and the discovery of new inhibitors. Crystal structures of neuraminidase-inhibitor complexes were used alongside modeled complexes to derive QSAR models by COMparative BINding Energy (COMBINE) analysis (Ortiz, A. R.; Pisabarro, M. T.; Gago, F.; Wade, R. C. J. Med. Chem. 1995, 38, 2681-2691). The neuraminidase proteins studied include type A subtypes N2 and N9 (which have ca. 50% sequence identity) and an active site mutant of the N9 subtype. The inhibitors include sialic acid and benzoic acid analogues with diverse frameworks and substitution groups. By considering the contributions of the protein residues and a key water molecule to the electrostatic and van der Waals intermolecular interaction energies, a predictive and robust QSAR model for binding to type A neuraminidase was obtained. In this QSAR model, 12 protein residues and 1 bound water molecule are highlighted as particularly important for inhibitory activity. This QSAR model provides guidelines for structural modification of current inhibitors and the design of novel inhibitors in order to optimize inhibitory activity.