The mitochondrial genome is highly susceptible to damage by reactive oxygen species (ROS) generated endogenously as a byproduct of respiration. ROS-induced DNA lesions, including oxidized bases, abasic (AP) sites, and oxidized AP sites, cause DNA strand breaks and are repaired via the base excision repair (BER) pathway in both the nucleus and mitochondria. Repair of damaged bases and AP sites involving 1-nucleotide incorporation, named single nucleotide (SN)-BER, was observed with mitochondrial and nuclear extracts. During SN-BER, the 5-phosphodeoxyribose (dRP) moiety, generated by AP-endonuclease (APE1), is removed by the lyase activity of DNA polymerase ␥ (pol ␥) and polymerase  in the mitochondria and nucleus, respectively. However, the repair of oxidized deoxyribose fragments at the 5 terminus after strand break would require 5-exo/endonuclease activity that is provided by the flap endonuclease (FEN-1) in the nucleus, resulting in multinucleotide repair patch (long patch (LP)-BER). Here we show the presence of a 5-exo/endonuclease in the mitochondrial extracts of mouse and human cells that is involved in the repair of a lyase-resistant AP site analog via multinucleotide incorporation, upstream and downstream to the lesion site. We conclude that LP-BER also occurs in the mitochondria requiring the 5-exo/endonuclease and pol ␥ with 3-exonuclease activity. Although a FEN-1 antibody cross-reacting species was detected in the mitochondria, it was absent in the LP-BER-proficient APE1 immunocomplex isolated from the mitochondrial extract that contains APE1, pol ␥, and DNA ligase 3. The LP-BER activity was marginally affected in FEN-1-depleted mitochondrial extracts, further supporting the involvement of an unidentified 5-exo/endonuclease in mitochondrial LP-BER.The mammalian mitochondrion contains 5-15 copies of the circular 16-kb mitochondrial (mt) 2 genome, and each mammalian cell thus may contain a thousand or more copies of the mt genome (1). MtDNA, encoding 13 subunits of the electron transport chain and containing genes for ribosomal RNAs and tRNAs (2), is extremely susceptible to oxidative damage, presumably because of the lack of protective histones and proximity to reactive oxygen species (ROS), which are endogenously generated by the electron transport complexes (3, 4). Such damage includes several dozen oxidized bases, abasic (AP) sites, and oxidation products of AP sites leading to DNA strand breaks (5). Endogenous mutations in mtDNA, likely to arise from these lesions, were shown to be considerably higher than in the nuclear genome (6). Approximately 10,000 AP sites were estimated to be generated per nuclear genome per day (7). Analysis of the release of 5-methylene-2-furanone, the product of -, ␥-elimination of 2-deoxyribonolactone, an oxidized AP site, causing DNA strand breakage, suggests that this ribonolactone could account for 70% of the total sugar damage in DNA (8, 9). The oxidized AP sites, whose level is likely to be high especially in the mtDNA, should block replication and transcription a...