Mitochondrial disorders are a group of genetic metabolic diseases characterized in impaired oxidative phosphoryla⁃ tion in the mitochondria, and any of the organs in patients with mitochondrial disorders may damage due to energy metabolism disor⁃ ders, which brings great challenge for anesthesia management during the perioperative period. The current review reports the anesthe⁃ sia management of an adult patient with mitochondrial disorders who underwent arthroscopic rotator cuff repair, and summarizes anes⁃ thesia choices, perioperative monitoring and medication recommendation.