Despite advanced knowledge on the genetic basis of oxidative phosphorylation-related diseases, the molecular and/or cellular determinants for tissue-specific dysfunction are not completely understood. Here, we report the cellular events associated with mitochondrial respiratory Complex II deficiency occurring before cell death. Mutation or chronic inhibition of Complex II determined a large increase of basal and agonist-evoked Ca 2 þ signals in the cytosol and the mitochondria, in parallel with mitochondrial dysfunction characterized by membrane potential (Dw mit ) loss, [ATP] reduction and increased reactive oxygen species production. Cytosolic and mitochondrial Ca 2 þ overload are linked to increased endoplasmic reticulum (ER) Ca 2 þ leakage, and to SERCA2b and PMCA proteasome-dependent degradation. Increased [Ca 2 þ ] mit is also contributed by decreased mitochondrial motility and increased ER-mitochondria contact sites. Interestingly, increased intracellular [Ca 2 þ ] activated on the one hand a compensatory Ca 2 þ -dependent glycolytic ATP production and determined on the second hand mitochondrial pathology. These results revealed the primary function for Ca 2 þ signalling in the control of mitochondrial dysfunction and cellular bioenergetics outcomes linked to respiratory chain Complex II deficiency. Mitochondria are the driving force behind life, as mitochondrial oxidative phosphorylation provides the main source of ATP in the cell. In addition to energy production, mitochondria have a crucial function in mediating amino-acid biosynthesis, fatty acid oxidation, intermediate metabolic pathways, free radicals production and Ca 2 þ homeostasis. 1 Mitochondria affect intracellular Ca 2 þ metabolism in two ways: (i) directly by regulating both the amplitude, duration, location and propagation of cytosolic Ca 2 þ elevations and the recycling of Ca 2 þ towards the endoplasmic reticulum (ER) and 2 (ii) indirectly by producing ATP, which is used by Ca 2 þ -dependent ATPases to pump Ca 2 þ out of the cell (by the plasma-membrane Ca 2 þ ATPase: PMCA) or into intracellular stores (by the sarco-ER Ca 2 þ ATPase: SERCA). Conversely, Ca 2 þ entering to the mitochondrial matrix regulates mitochondrial metabolism through the activation of the Ca 2 þ -dependent enzymes of the Krebs cycle. 3 Leigh's syndrome is a rare but severe and fatal encephalopathy of early childhood that is most frequently associated with deficiencies in nucleus-encoded subunits of Complex I (NDUFS3 and NDUFS7), 4,5 Complex II (SDHA), 6 Complex IV (SURF1) 7 or pyruvate dehydrogenase. 8 Despite the identification of the genetic origin of Leigh's syndrome, the molecular and cellular events associated with pathology are not completely understood.Deregulations of intracellular Ca 2 þ signalling have been reported in different models of mitochondrial respiratory chain diseases, 9-11 whereas data on Complex II deficiency are still lacking.Complex II (succinate: ubiquinone (UQ) oxidoreductase) has a central function in oxidative metabolism, being an importan...