The permanent transfer of specific mtDNA sequences into mammalian cells could generate improved models of mtDNA disease and support future cell-based therapies. Previous studies documented multiple biochemical changes in recipient cells shortly after mtDNA transfer, but the long-term retention and function of transferred mtDNA remains unknown. Here, we evaluate mtDNA retention in new host cells using 'MitoPunch', a device that transfers isolated mitochondria into mouse and human cells. We show that newly introduced mtDNA is stably retained in mtDNA-deficient (ρ0) recipient cells following uridine-free selection, although exogenous mtDNA is lost from metabolically impaired, mtDNA-intact (ρ+) cells. We then introduced a second selective pressure by transferring chloramphenicol-resistant mitochondria into chloramphenicol-sensitive, metabolically impaired ρ+ mouse cybrid cells. Following double selection, recipient cells with mismatched nuclear (nDNA) and mitochondrial (mtDNA) genomes retained transferred mtDNA, which replaced the endogenous mutant mtDNA and improved cell respiration. However, recipient cells with matched mtDNA-nDNA failed to retain transferred mtDNA and sustained impaired respiration. Our results suggest that exogenous mtDNA retention in metabolically impaired ρ+ recipients depends on the degree of recipient mtDNA-nDNA co-evolution. Uncovering factors that stabilize exogenous mtDNA integration will improve our understanding of in vivo mitochondrial transfer and the interplay between mitochondrial and nuclear genomes. Mutations in the multi-copy mitochondrial genome (mtDNA) can impair the biosynthesis of ATP, metabolites, fatty acids, reactive oxygen species, and iron sulfur clusters 1-4. Even a single nucleotide polymorphism can have profound effects on cellular function and contribute to pathologies including cardiomyopathies, diabetes, autoimmune diseases, neurological disorders, cancer, and even aging 5,6. The degree of pathology often depends on the ratio of mutant to wild-type mtDNA populations within the same cell, a situation known as heteroplasmy 7. One in 5,000 people have some degree of a pathological mtDNA disorder, and up to 1 in 8 individuals carry low levels of a mtDNA mutation that can be inherited through the maternal germline 8-11. Mitochondrial replacement therapy (MRT) aims to prevent transmission of mtDNA disorders from affected mothers to offspring, but limited treatments exist for those already living with a pathological mtDNA mutation 12,13. Our ability to repair mutant mtDNA and improve metabolically impaired cells would advance disease modeling studies and potential cell-based therapies for mtDNA disorders. Gene therapy and now gene editing is a viable treatment option for some nucleus-encoded disorders 5,14,15. In contrast, specific mtDNA mutations are difficult to generate or repair because current gene modifying approaches do not work well inside mitochondria.