Adenocarcinomas from multiple tissues can converge to treatment-resistant small cell neuroendocrine (SCN) cancers comprised of ASCL1, POU2F3, NEUROD1, and YAP1 subtypes. We investigated how PGC-1a, a potent regulator of mitochondrial oxidative phosphorylation (OXPHOS), influences SCN cancer (SCNC) progression. Comprehensive bioinformatics analyses across thousands of patient tumors and human cancer cell lines, and in multiple clinical SCNC datasets, revealed increased PGC-1a expression in multiple SCNC types. PGC-1a correlated tightly with increased ASCL1 expression through a positive feedback mechanism. Analyses using a human prostate tissue-based SCN transformation system showed that the ASCL1 subtype has heightened PGC-1a expression and OXPHOS activity. PGC-1a inhibition blunted OXPHOS, reduced SCNC cell proliferation, and blocked SCN prostate tumor formation. PGC-1a overexpression enhanced OXPHOS, tripled the SCN prostate tumor formation rate, and promoted commitment to the ASCL1 lineage. These observations reveal the metabolic heterogeneity among SCNC subtypes and identify PGC-1a-induced OXPHOS as a regulator of SCNC lineage plasticity.