Differences among cystic fibrosis (CF) genotypes (CF, obligate carriers for CF [HZ], and controls) in mitochondrial calcium pool size, oxygen (O2) consumption, and rotenone inhibition of O2 consumption led to examination of mitochondrial NADH dehydrogenase (NADH: [acceptor] oxidoreductase, E.C. 1.6.99.3). pH optima of mitochondrial NADH dehydrogenase were different in enzyme derived from whole cell homogenates of cultured skin fibroblasts of subjects with CF, HZ, and controls. We describe here apparent binding of substrate to the enzyme (Km [NADH]) in cell fractions. Km (NADH) for CF ranged from 10.9 to 16.1 micro M (no. = 7); for HZ from 20.9 to 26.3 microM (no. = 5). With three exceptions, Km for controls (no. = 12) ranged from 31.8 to 42.8 microM. Km of the three exceptional controls were 21.5, 23.7, and 22.4 microM (the latter two are identical twins). pH optima of enzyme from these three strains were no different from that of known HZ. The correlation between two kinetic parameters of an enzyme and the three CF genotypes suggests an association between the CF gene and mitochondrial NADH dehydrogenase.