Mitochondrial transplantation is a therapeutic approach developed by McCully and colleagues that entails the injection of healthy mitochondria harvested from unaffected tissue into an ischemic organ of the same subject (1). It has recently been applied to human pediatric patients with myocardial ischemia (2), receiving widespread media attention accompanied by sensationalistic claims on its mechanism of action, e.g.: (a) after injection into the heart, "mitochondria moved like magnets to the proper places in the cells and began supplying energy;" and (b) after infusion into the coronary arteries, "somehow the organelles will gravitate almost magically to the injured cells that need them and take up residence" (3). According to the purported mechanism of action, the mitochondria must, seemingly, perform three "magic tricks." First, the mitochondria must survive transfer from an intracellular environment to an extracellular one with high Ca 2+ concentrations. Second, if they survive, mitochondria must produce ATP that is able to enter cardiac myocytes to support contraction. Third, enough mitochondria must pass through the cell membrane to contribute to ATP production by the host cell. A corollary to trick number three is a variation in which the mitochondria are injected into the bloodstream and somehow pass through the endothelial vascular permeability barrier, migrate into the interstitium, and are incorporated into the dysfunctional target tissue. Given the rapid translation of this method to the clinic, it behooves us to determine whether these extraordinary claims are convincingly supported.