Abstract In oncology, the occurrence of distant metastases often marks the transition from curative to palliative care. Such outcome is highly predictable for triple-negative and HER2-positive breast cancer patients, even if tumors are detected early, and there is no treatment to prevent metastasis. Here, considering that mitochondria are bioenergetic sensors of the tumor microenvironment, we report in preclinical mouse models that human breast cancer relapse is not a fatality: local recurrence and metastatic dissemination can be prevented by MitoQ, a mitochondria-targeted antioxidant that already underwent Phase I safety and Phase II efficacy trials in humans for pathologies other than cancer. Metastatic prevention was confirmed in the MMTV-PyMT model of spontaneously metastatic mouse breast cancer. After oral delivery, MitoQ was effective at nanomolar concentrations at which nonmalignant cells were spared. In anticipation of future clinical trials, a robust signature of the response to MitoQ was defined, applicable to bulk primary tumor biopsies. Citation Format: Tania Capeloa, Pierre Sonveaux. Mitochondria-targeted antioxidant MitoQ inhibits human breast cancer metastasis in mice [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4129.