Non-aqueous Li-O2 batteries are promising for next generation energy storage. New battery chemistries based on LiOH, rather than Li2O2, have recently been reported in systems with added water, one using a soluble additive LiI and the other using solid Ru catalysts. Here, we focus on the mechanism of Ru-catalyzed LiOH chemistry. Using nuclear magnetic resonance, operando electrochemical pressure measurements and mass spectrometry, we show that on discharging LiOH forms via a 4 e- oxygen reduction reaction, the H in LiOH coming solely from added H2O and the O from both O2 and H2O. On charging, quantitative LiOH oxidation occurs at 3.1 V, with O being trapped in a form of dimethyl sulfone in the electrolyte. Compared to Li2O2, LiOH formation over Ru incurs hardly any side reactions, a critical advantage for developing a long-lived battery. An optimized metal catalyst-electrolyte couple needs to be sought that aids LiOH oxidation and is able stable towards attack by hydroxyl radicals.