Abbreviations: 12S rRNA, Mitochondrial ribosomal 12S rRNA; D-loop, Displacement loop; IQR, Interquartile range; mtDNA, Mitochondrial DNA; mtDNMT1, Mitochondrial isoform of nuclear-encoded DNA methyltransferase enzyme 1;MT-RNR1, Mitochondrial region RNR1; PM, Particulate matter.Most research to date has focused on epigenetic modifications in the nuclear genome, with little attention devoted to mitochondrial DNA (mtDNA). Placental mtDNA content has been shown to respond to environmental exposures that induce oxidative stress, including airborne particulate matter (PM). Damaged or non-functioning mitochondria are specifically degraded through mitophagy, exemplified by lower mtDNA content, and could be primed by epigenetic modifications in the mtDNA. We studied placental mtDNA methylation in the context of the early life exposome. We investigated placental tissue from 381 mother-newborn pairs that were enrolled in the ENVIRONAGE birth cohort. We determined mtDNA methylation by bisulfite-pyrosequencing in 2 regions, i.e., the D-loop control region and 12S rRNA (MT-RNR1), and measured mtDNA content by qPCR. PM 2.5 exposure was calculated for each participant's home address using a dispersion model. An interquartile range (IQR) increment in PM 2.5 exposure over the entire pregnancy was positively associated with mtDNA methylation (MT-RNR1: C0.91%, P D 0.01 and D-loop: C0.21%, P D 0.05) and inversely associated with mtDNA content (relative change of ¡15.60%, P D 0.001) in placental tissue. mtDNA methylation was estimated to mediate 54% [P D 0.01 (MT-RNR1)] and 27% [P D 0.06 (D-loop)] of the inverse association between PM 2.5 exposure and mtDNA content. This study provides new insight into the mechanisms of altered mitochondrial function in the early life environment. Epigenetic modifications in the mitochondrial genome, especially in the MT-RNR1 region, substantially mediate the association between PM 2.5 exposure during gestation and placental mtDNA content, which could reflect signs of mitophagy and mitochondrial death.