The Second Biennial Mitochondrial Biology Conference took place in Seattle on September 12-13, 2015. The conference was hosted by Seattle Children’s Research Institute in collaboration with our guild and brought together renowned leaders in the field of mitochondrial disease research and patient care. Discussion focused mainly on the newly recognized atypical presentations of mitochondrial diseases, with an emphasis on new therapies that are giving new cause for hope. This two day conference was open to medical professional as well as families and we had attendees from all across the country. Speakers included Professor Patrick Chinnery from the University of Newcastle upon Tyne, Great Britain, Professor David Thorburn, Murdoch Children’s Research Institute, University of Melbourne Australia, Michio Hirano, MD Professor of Neurology Columbia University Medical Center and Bruce H. Cohen, MD, FAAN, Director, Pediatric Neurology, Akron Children’s Hospital.