The plateau is a unique environment with low pressure, low oxygen and high cold. The plateau environment will reduce the metabolism of energy substances and mitochondrial work, thus affecting the plateau operation. In recent years, mitochondrial damage has attracted wide attention. As the energy factory of cells, mitochondria are closely linked to the movement of the body. We focused our attention on mitochondrial damage at high altitude, and summarized the effects of high altitude on the metabolism of basic energy substances and the changes of key enzyme activities and mitochondrial structure and function in mitochondrial biochemical energy supply response. It was found that protein, carbohydrate and lipid metabolism was negatively affected at high altitude, resulting in fatigue, hyperlipidemia and body repair. The activities of enzymes related to pyruvate metabolism, tricarboxylic acid cycle, β-oxidation and oxidative phosphorylation are inhibited, and the morphology and number of mitochondria are changed, which will lead to impaired mitochondrial function and affect exercise energy supply. In the future, the exploration of the mechanism of plateau cell injury will vigorously promote the research of plateau injury prevention and treatment drugs.