Background: Assembly of cytochrome c oxidase (COX), complex IV of the respiratory chain, requires a great number of accessory proteins known as assembly factors. Results: hCOA3 interacts with newly synthesized COX1 and promotes its assembly with subsequent COX subunits. Conclusion: hCOA3 participates in COX biogenesis in humans. Significance: hCOA3 is a new candidate gene to screen in patients with COX deficiency.