MED11 is an essential subunit of the Mediator head module that couples transcriptional activator signals to the assembly of the RNA polymerase II preinitiation complex (PMID:9812975, PMID:18691966). Within the head module, MED11 (Med11) and Med22 form a conserved four-helix bundle heterodimer whose C-terminal extensions bind the central head subunit Med17, anchoring it within the neck submodule of the head (PMID:21498544, PMID:23123849). A highly conserved surface patch on this bundle directly engages the TFIIH subunit Rad3 and is required for stable PIC formation; disrupting the Med11-Rad3 interaction impairs recruitment of TFIIH, TFIIE, and Pol II, and reduces genome-wide Pol II CTD serine 5 phosphorylation (PMID:18691966, PMID:21498544). Genetic loss of MED11 produces activator-specific transcriptional defects rather than a global shutdown, consistent with a role in conveying particular activation signals (PMID:9891034). Human MED11 is required for Tat-dependent transcription of HIV-1 at a post-integration step (PMID:25100719), and a homozygous truncating variant (p.Arg109Ter) that disrupts the MED11 C-terminus causes a lethal neurodegenerative disease, with a zebrafish knockout recapitulating key phenotypes (PMID:36001086).