The osmotic movement of water into and out of the mitochondrial matrix underlies the extraordinary plasticity that characterizes mitochondria, a feature of pivotal importance to cell bioenergetics and signaling, and of critical relevance to life-and-death cell decision. However, the biophysics and identity of mitochondrial water transport had remained mostly unexplored, until recent works suggesting high water permeability and the presence of multiple facilitated pathways of water diffusion in liver mitochondria. Here, we attempt to summarize our current view of the mechanisms of mitochondrial water transport and possible relevance of the channel-mediated pathways created by mitochondrial permeability transition, aquaporins and protein/lipid specializations. Assessing the molecular bases and dynamics of mitochondrial water permeability will help to answer the much-debated question over the role of mitochondria in apoptotic and necrotic cell death.