There are more than 1,000 metabolic disorders among which a large fraction affects energy metabolism in mitochondria, the powerhouses of our cells. Several mitochondrial disorders are amenable to treatment, often with a simple diet change such as vitamin supplementation. However, pinpointing the genetic cause of mitochondrial disorders and determining the appropriate treatment remains open for most affected individuals. To address this challenge, the Eurasian personalised mitochondrial medicine project (PerMiM) aims for early diagnosis by integrating information on the patient’s genes, metabolites, and proteins. Early diagnosis guides the patient’s management and defines personalised treatments targeted to their individual need. Moreover, where the disease cause is still unclear, we will characterize the molecular response of patient cells to various treatments and translate these results into advanced clinical management. In parallel, health-economic analysis of this multi-centre project will contribute to improved evidence-based best practice.