During chromosome replication, the nascent leading strand is synthesized by DNA polymerase epsilon (Pol epsilon), which associates with the sliding clamp processivity factor proliferating cell nuclear antigen (PCNA) to form a processive holoenzyme. For high-fidelity DNA synthesis, Pol epsilon relies on nucleotide selectivity and its proofreading ability to detect and excise a misincorporated nucleotide. Here, we present cryo-electron microscopy (cryo-EM) structures of human Pol epsilon in complex with PCNA, DNA and an incoming nucleotide, revealing how Pol epsilon associates with PCNA through its PCNA-interacting peptide box and additional unique features of its catalytic domain. Furthermore, by solving a series of cryo-EM structures of Pol epsilon at a mismatch-containing DNA, we elucidate how Pol epsilon senses and edits a misincorporated nucleotide. Our structures delineate steps along an intramolecular switching mechanism between polymerase and exonuclease activities, providing the basis for a proofreading mechanism in B-family replicative polymerases. Using cryo-electron microscopy, the authors deepen our mechanistic understanding of nascent leading-strand synthesis during human DNA replication and provide the basis for a proofreading mechanism in B-family replicative polymerases.