Purpose of review Coenzyme Q(10) is administered for an ever-widening range of disorders, therefore it is timely to illustrate the latest findings with special emphasis on areas in which this therapeutic approach is completely new. These findings also give further insight into the biochemical mechanisms underlying clinical involvement of coenzyme Q(10). Recent findings Cardiovascular properties of coenzyme Q(10) have been further addressed, namely regarding myocardial protection during cardiac surgery, end-stage heart failure, pediatric at cardiomyopathy and in cardiopulmonary resuscitation. The vascular aspects of coenzyme Q(10) addressing the important field of endothelial function are briefly examined. The controversial issue of the statin/coenzyme Q(10) relationship, has been investigated in preliminary studies in which the,two substances were administered simultaneously. Work on different neurological diseases, involving mitochondrial dysfunction and oxidative stress, highlights some of the neuroprotective mechanisms of coenzyme Q(10). A 4-year follow-up on 10 Friedreich's Ataxia patients treated with coenzyme Q(10) and vitamin E showed a substantial improvement in cardiac and skeletal muscle bioenergetics and heart function. Mitochondrial dysfunction likely plays a role in the pathophysiology of migraine as well as age-related macular degeneration and a therapy including coenzyme Q(10) produced significant improvement. Finally, the effect of coenzyme Q(10) was evaluated in the treatment of asthenozoospermia. Summary The latest findings highlight the beneficial role of coenzyme Q(10) as coadjuvant in the treatment of syndromes, characterized by impaired mitochondrial bioenergetics and increased oxidative stress, which have a high social impact. Besides their clinical significance, these data give further insight into the biochemical mechanisms of coenzyme Q(10) activity.