PINK1 is a ubiquitin kinase that accumulates on the outer membrane of damaged mitochondria. Upon accumulation, PINK1 dimerises and trans-autophosphorylates, resulting in conformational changes that enable it to bind and phosphorylate ubiquitin. Together with the E3 ligase Parkin, the phospho-ubiquitin signal is amplified to trigger mitophagy. These processes critically depend on the initial stabilisation of PINK1 on the surface of damaged mitochondria, specifically at the site of the Translocase of the Outer Membrane (TOM complex). Previous studies investigating the activation mechanism of PINK1 have relied on the recombinantly expressed kinase domain of insect PINK1. Using single particle cryo-electron microscopy, we determine the structure of dimeric preactive human PINK1 on the TOM complex to a resolution of 3.1 Å. This is the first structure of human PINK1 and resolves the passage of the PINK1 N-terminus through the TOM40 beta barrels, finally revealing how PINK1 is stabilised at the TOM complex. Surprisingly, the structure reveals an unusual assembly of two TOM complexes joined by a VDAC2 homodimer. This structure challenges previous models on the mode of ubiquitin phosphorylation by PINK1 and also uncovers a redox regulatory mechanism for PINK1 activation. Our PINK1-TOM-VDAC model rationalises patient mutations and opens new avenues for the therapeutic targeting of PINK1 to boost mitophagy in Parkinson’s disease.