Fairly recently, it was recognized that human ribosomopathiesdevelopmental defects caused by mutations in ribosome biogenesis proteinscan exhibit tissue-specific defects rather than the expected global defects. This apparent anomalythat seemingly ubiquitously expressed and required ribosomal proteins can have distinct functions in cell and tissue differentiationhas spurred new areas of research focused on better understanding translational mechanisms, biogenesis, and function in diverse cell types. This renewed appreciation for, and need to better understand, roles for ribosomal proteins in human development and disease has identified surprising similarities and differences in a variety of human ribosomopathies. Here, we discuss ribosomal protein functions in health and disease, focusing on the ribosome biogenesis protein Utp5/WDR43. New and exciting research in this field is anticipated to provide insight into a variety of previously understudied craniofacial dysostoses and result in significantly improved knowledge and understanding of roles for translational machinery in human craniofacial development and disease.