F 1 F o -ATP synthases are universal energy-converting membrane protein complexes that synthesize ATP from ADP and inorganic phosphate. In mitochondria of yeast and mammals, the ATP synthase forms V-shaped dimers, which assemble into rows along the highly curved ridges of lamellar cristae. Using electron cryotomography and subtomogram averaging, we have determined the in situ structure and organization of the mitochondrial ATP synthase dimer of the ciliate Paramecium tetraurelia. The ATP synthase forms U-shaped dimers with parallel monomers. Each complex has a prominent intracrista domain, which links the c-ring of one monomer to the peripheral stalk of the other. Close interaction of intracrista domains in adjacent dimers results in the formation of helical ATP synthase dimer arrays, which differ from the loose dimer rows in all other organisms observed so far. The parameters of the helical arrays match those of the cristae tubes, suggesting the unique features of the P. tetraurelia ATP synthase are directly responsible for generating the helical tubular cristae. We conclude that despite major structural differences between ATP synthase dimers of ciliates and other eukaryotes, the formation of ATP synthase dimer rows is a universal feature of mitochondria and a fundamental determinant of cristae morphology.cryoelectron microscopy | subtomogram averaging | Paramecium | macromolecular organization | serial block face imaging F 1 F o -ATP synthases are ubiquitous, highly conserved energyconverting membrane protein complexes. ATP synthases produce ATP from ADP and inorganic phosphate (P i ) by rotary catalysis (1, 2) using the energy stored in a transmembrane electrochemical gradient. The ∼600-kDa monomer of the mitochondrial ATP synthase is composed of a soluble F 1 subcomplex and a membranebound F o subcomplex (3). The main components of the F 1 subcomplex are the (αβ) 3 hexamer and the central stalk (4). The F o subcomplex includes a rotor ring of 8-15 hydrophobic c subunits (5), the peripheral stalk, and several small hydrophobic stator subunits. Protons flowing through the membrane part of the F o subcomplex drive the rotation of the c-ring (6-9). The central stalk transmits the torque generated by c-ring rotation to the catalytic head of the F 1 subcomplex, where it induces conformational changes of the α and β subunits that result in phosphate bond formation and the generation of ATP. The catalytic (αβ) 3 hexamer is held stationary relative to the membrane region by the peripheral stalk (10, 11). Several high-resolution structures of the F 1 /rotor ring complexes have been solved by X-ray crystallography (12-16), and the structure of the complete assembly has been determined by cryoelectron microscopy (cryo-EM) (10,(17)(18)(19)(20).In mitochondria, the ATP synthase forms dimers in the inner membrane. In fungi, plants, and metazoans, the dimers are V-shaped and associate into rows along the highly curved ridges of lamellar cristae (19)(20)(21)(22). F o subcomplexes of the two monomers in the dimer interact in...