The discovery of the ‘porosome’, the cell's secretory apparatus, has provided a platform for entry into a new era in drug development and therapy. The porosome has been isolated, its structure and composition determined, and it has been functionally reconstituted into live cells. Many diseases including Alzheimer’s and cystic fibrosis, result from secretory defects in the porosome. Undruggable porosome protein targets can now be addressed by incorporating the native functional porosome into diseased cells. Using cryo-EM and AI, the atomic structure of the neuronal porosome is being solved, that has allowed precision-targeting of small molecules to modulate secretory disorder, thereby treating the disease.