Myopathy literally means any disease in the muscle which can cause o weakness of the muscles. MYO- muscles PATHY- disease or suffering. There are various causes of muscle disease. Mitochondria are known as power house of each individual cell. Problems in the mitochondria can cause muscle weakness or other manifestations related to vision, hearing loss, seizures etc. In case of only muscle involvement, the individual can have exercise intolerance and chronic fatigue. Dr Yogesh and Dr Vaibhavi from Benglauru, Karnataka presented a report of a patient in the Indian rheumatology conference in Guwahati. A 19 year old girl had presented with chronic fatigue for past 6 months. On further evaluation with relevant blood tests and a muscle biopsy she was diagnosed with isolated mitochondrial myopathy. Although there is currently no cure, symptomatic treatment have been proven to improve the quality of life. Thus they emphasised that doctors need to maintain a high degree of suspicion to prevent under diagnosis of isolated mitochondrial myopathy which is a rare condition.