Uncoupling of mitochondrial proton pumping and adenosine triphosphate (ATP) production lowers mitochondrial efficiency. Current methods to determine mitochondrial efficiency require substantial amounts of tissue and permeabilization or isolation procedures. A simple histochemical method has been described by Meijer and Vloedman (Histochemistry 69:217–232, 1980, https://doi.org/10.1007/BF00489769), but this was not quantitative. We found linear correlations between (1) absorbance and sections thickness and (2) absorbance and incubation time. Because the method obeys Lambert–Beer’s law, we can estimate ATP/O2 ratios for healthy and overloaded right-sided rat myocardium. We related mitochondrial efficiency to the ratio between cardiolipin and its precursor phosphatidylglycerol. We found a non-linear relationship between mitochondrial efficiency and this ratio, indicating that lower mitochondrial efficiency as found in experimental pulmonary hypertension may be due to altered composition of the mitochondrial inner membrane. We conclude that the histochemical method of Meijer and Vloedman can be applied to quantify mitochondrial efficiency.