NAD is a vital redox carrier, and its degradation is a key element of important regulatory pathways. NAD-mediated functions are compartmentalized and have to be fueled by specific biosynthetic routes. However, little is known about the different pathways, their subcellular distribution, and regulation in human cells. In particular, the route(s) to generate mitochondrial NAD, the largest subcellular pool, is still unknown. To visualize organellar NAD changes in cells, we targeted poly-(ADP-ribose) polymerase activity into the mitochondrial matrix. This activity synthesized immunodetectable poly(ADPribose) depending on mitochondrial NAD availability. Based on this novel detector system, detailed subcellular enzyme localizations, and pharmacological inhibitors, we identified extracellular NAD precursors, their cytosolic conversions, and the pathway of mitochondrial NAD generation. Our results demonstrate that, besides nicotinamide and nicotinic acid, only the corresponding nucleosides readily enter the cells. Nucleotides (e.g. NAD and NMN) undergo extracellular degradation resulting in the formation of permeable precursors. These precursors can all be converted to cytosolic and mitochondrial NAD. For mitochondrial NAD synthesis, precursors are converted to NMN in the cytosol. When taken up into the organelles, NMN (together with ATP) serves as substrate of NMNAT3 to form NAD. NMNAT3 was conclusively localized to the mitochondrial matrix and is the only known enzyme of NAD synthesis residing within these organelles. We thus present a comprehensive dissection of mammalian NAD biosynthesis, the groundwork to understand regulation of NAD-mediated processes, and the organismal homeostasis of this fundamental molecule.NAD is an essential electron carrier and a key molecule of signaling pathways (1-4). In bioenergetic pathways, NAD is reversibly converted between its oxidized (NAD ϩ ) and reduced (NADH) states, which would not require continuous regeneration. Indeed, when the principal pathway of NAD ϩ synthesis from nicotinic acid (NA) 2 had been established (5), the "case" was nearly closed, because neither additional roles of NAD nor a regulatory importance of its synthesis were suspected. Meanwhile, discoveries of signaling processes in which NAD ϩ is degraded have dramatically changed this view. Signaling conversions of NAD ϩ include the cleavage to nicotinamide (Nam), which is recycled into NAD ϩ synthesis, and a concomitant reaction of the remaining ADP-ribose moiety. NAD ϩ -dependent deacetylases (members of the sirtuin family) and mono-ADP-ribosyltransferases control life span, the biological clock, insulin secretion, and key metabolic enzymes (6 -9). In addition, NAD ϩ represents the substrate for poly(ADP-ribosylation) to regulate DNA repair, transcription, telomerase activity, and chromatin dynamics (10 -12). NAD ϩ is also the precursor of cyclic ADP-ribose and NAADP, potent agents to mobilize calcium from intracellular stores (13). This multitude of NAD ϩ -degrading reactions clearly necessitates permanent re...