The eukaryotic translation initiation factor 5A (eIF5A) is a highly conserved protein and is essential in all eukaryotes. However, the specific roles of eIF5A in translation and in other biological processes remain elusive. In the present study, we described the role of eIF5A, its posttranslational modifications (PTM), and the biosynthetic pathway needed for the PTM inEntamoeba histolytica, the protozoan parasite responsible for amoebic dysentery and liver abscess in humans.E.histolyticaencodes two isotypes of eIF5A and two isotypes of enzymes, deoxyhypusine synthase (DHS), responsible for their PTM. Both of the two eIF5A isotypes are functional, whereas only one DHS (EhDHS1, but not EhDHS2), is catalytically active. The DHS activity increased ~2000-fold when EhDHS1 was co-expressed with EhDHS2 inEscherichia coli, suggesting that the formation of a heteromeric complex is needed for full enzymatic activity. BothEhDHS1and2genes were required forin vitrogrowth ofE.histolyticatrophozoites, indicated by small antisense RNA-mediated gene silencing. In trophozoites, onlyeIF5A2, but noteIF5A1, gene was actively transcribed. Gene silencing ofeIF5A2caused compensatory induction of expression ofeIF5A1gene, suggesting interchangeable role of the two eIF5A isotypes and also reinforcing the importance of eIF5As for parasite proliferation and survival. Furthermore, using a sibling species,Entamoeba invadens, we found thateIF5A1gene was upregulated during excystation, whileeIF5A2was downregulated, suggesting thateIF5A1gene plays an important role during differentiation. Taken together, these results have underscored the essentiality of eIF5A and DHS, for proliferation and potentially in the differentiation of this parasite, and suggest that the hypusination associated pathway represents a novel rational target for drug development against amebiasis.