The release of proteins from the intermembrane space of mitochondria is one of the pivotal events in the apoptotic process, which can lead to the activation of caspases and the ultimate demise of the cell. How these proteins exit the mitochondria is still a matter of intense debate. Here, we discuss the possible mechanisms behind the release of apoptogenic proteins, the ways in which cancer cells subvert these mechanisms, and the therapeutic regimens that aim to promote the timely loss of integrity of the outer mitochondrial membrane.