SUCO (SUN domain containing ossification factor) is a bone development regulator required for skeletal homeostasis and osteoblast maturation. The protein localizes to the endoplasmic reticulum and cytoplasm, where it positively regulates type I collagen biosynthesis and osteoblast differentiation 1. Mechanistically, SUCO interacts with TAPT1 in the endoplasmic reticulum to maintain newly synthesized protein homeostasis critical for proper development 1. Disease relevance spans multiple systems. SUCO mutations are associated with skeletal dysplasia, identified as a candidate disease gene in a large cohort of 411 patients 2, and variant accumulation in SUCO correlates with atypical femoral fracture risk in patients receiving anti-resorptive therapy 3. The gene also plays unexpected roles in neurological development; SUCO mutations were identified in mesial temporal lobe epilepsy patients, with knockdown reducing dendritic length in vitro, suggesting involvement in neuronal development 4. Additionally, SUCO upregulation was detected in hepatocellular carcinoma tissues with prognostic implications 5, and it was identified as an immune-related prognostic molecule in cutaneous melanoma 6. Clinically, SUCO emerges as a potential diagnostic and prognostic biomarker across skeletal, neurological, and malignant diseases, though validation in larger patient cohorts is needed.