Propionic acidemia (PA) is a rare and life threatening metabolic disorder caused by deficiency of a mitochondrial biotin-dependent enzyme known as propionyl coenzyme-A carboxylase (PCC). PCC is required for the catabolism of metabolites that arise from the normal turnover of several essential amino acids (e.g., methionine, isoleucine, valine and threonine) and odd chain fatty acids [1,2]. Specifically, PCC catalyzes the carboxylation of the metabolic intermediate propionyl coenzyme-A (PP-COA) to methyl malonyl coenzyme-A (MM-COA) in the matrix of mitochondria (Figure 1) [3]. The native PCC holoenzyme comprises six a and six b subunits [4]. Studies on the biochemical aspects of PCC have shown that PA can occur in patients that have mutations in one or both genes coding for the PCCa and PCCb subunits [1].The deficiency of PCC and the subsequent accumulation of PP-COA lead to the pathogenesis of PA. The most common clinical manifestations of PA include high anion-gap metabolic acidosis, ketonuria and hyperammonemia, which are frequently of sufficient severity to result in neonatal death [3]. Moreover, increased organic acids in the urine, elevated plasma glycine levels, and the characteristic increase in propionylcarnitine (C3) levels are also observed in PA patients. Therefore, detection of the accumulation of propionic acid and other related metabolites forms the basis for the initial screening and examination of patients with suspected PA. In Background: Propionyl coenzyme-A carboxylase (PCC) is a mitochondrial enzyme previously quantifiable only by radiometric assay. Herein, we report a UPLC-MS/MS method as a superior alternative method for assaying PCC's activity. Methodology & Results: For the development of the UPLC-MS/MS method, the mass spectra of propionyl coenzyme-A and methyl malonyl coenzyme-A precursor ions, and their full scan product ions were determined. MRM was used for the quantification of the analytes. The method showed good linearity and selectivity for further bioanalytical study. Conclusion: The developed UPLC-MS/MS method is capable of rapidly quantifying PCC's enzymatic activity and demonstrated suitability for assaying PCC's activity in complex biological samples. Thus, the method will be useful in validating recombinant expression of PCC, and potentially for routine quantification of mitochondrial PCC's activity level in patient cells.