Mitochondrial dysfunction is associated with many neurodegenerative disorders and is particularly prominent in conditions tied toPOLGmutations.POLGencodes DNA polymerase gamma vital for mitochondrial DNA replication. Employing 3D human pluripotent stem cell-derived midbrain organoids (hMOs), harbouringPOLGmutations, this study explores their differentiation, transcriptional alterations, and underlying pathways of neurodegeneration associated withPOLGmutations. The generated hMOs displayed midbrain specificity and, at three months, a reduced diameter, suggesting growth challenges fromPOLGmutations. A reduced presence of dopaminergic neurons, particularly in DA2 and ventral midbrain classes, was evident. Intriguingly, post-treatment with 1 mM Nicotinamide Riboside (NR), an NAD+precursor, the organoids demonstrated an increased count of DA and VMN neurons and an elevated gene expression, especially in processes crucial to mitochondrial and synaptic functions. Our findings spotlight NAD+supplementation has potential therapeutic value in addressing POLG-associated neuronal and mitochondrial deficits. Moreover, the unique insights garnered from single-cell RNA sequencing, and enrichment analyses further emphasize the significance of mitochondrial disturbances and potential interventions for POLG-related neurodegenerative conditions. In summary, we underscore the transformative potential of NAD+in managing neurodegenerative diseases associated withPOLGmutations. It also establishes the utility ofPOLGmutant hMOs as a potent research model.