Objective: Simultaneously measuring of both the ligand-binding and the gating of ligand-gated ion channels will provide important novel insight in receptor and channel function (see e.g. Edelstein, S.J., Schaad, O., Changeux, J.P.,1997. Biochemisty 36(45), 13755-60). Methods: Such measurements require a fluorescently labeled agonist as ligand, single molecule sensitive optical and electrical detection, micro-second time-resolution, and optimal alignment of the optical and electrophysiological single-channel acquisition parts. We use APD-based fast confocal detection and conventional patch-clamping in single channel mode. Results: Here we present first results of experiments on the human muscle nicotinic acetylcholine receptor in living cells measuring simultaneously (i) the binding of individual fluorescent agonist molecules to the LGIC and (ii) the subsequent opening of a single ion channel. The distribution of Dt between these events can be described by a 3/2-power-law indicating that the LGIC undergoes conformational fluctuations between multiple structural states towards channel activation. Conclusion: With the presented approach the liganded, closed state becomes directly experimentally accessible. The dwell time of this state is distinctively different from the overall closed-time distribution. The observed power-law is in good agreement with normal conformational diffusion towards the open state.