The enzymic stages of mammalian mitochondrial beta-oxidation were eluc
idated some 30-40 years ago. However, the discovery of a membrane-asso
ciated multifunctional enzyme of beta-oxidation, a membrane-associated
acyl-CoA dehydrogenase and characterization of the carnitine palmitoy
l transferase system at the protein and at the genetic level has demon
strated that the enzymes of the system itself are incompletely underst
ood. Deficiencies of many of the enzymes have been recognized as impor
tant causes of disease. In addition, the study of these disorders has
led to a greater understanding of the molecular mechanism of beta-oxid
ation and the import, processing and assembly of the beta-oxidation en
zymes within the mitochondrion. The tissue-specific regulation, intram
itochondrial control and supramolecular organization of the pathway is
becoming better understood as sensitive analytical and molecular tech
niques are applied. This review aims to cover enzymological and organi
zational aspects of mitochondrial beta-oxidation together with the bio
chemical aspects of inherited disorders of beta-oxidation and the intr
insic control of beta-oxidation.