Joubert syndrome (JBTS) is a recessive neurodevelopmental ciliopathy, characterized by a pathognomonic hindbrain malformation. All known JBTS-genes encode proteins involved in the structure or function of primary cilia, ubiquitous antenna-like organelles essential for cellular signal transduction. Here, we use the recently identified JBTS-associated protein ARMC9 in tandem-affinity purification and yeast twohybrid screens to identify a novel ciliary module composed of ARMC9-TOGARAM1-CCDC66-CEP104-CSPP1. TOGARAM1-variants cause JBTS and disrupt its interaction with ARMC9. Using a combination of protein interaction analyses and characterization of patient-derived fibroblasts, CRISPR/Cas9-engineered zebrafish and hTERT-RPE1 cells, we demonstrate that dysfunction of ARMC9 or TOGARAM1 results in short cilia with decreased axonemal acetylation and glutamylation, but relatively intact transition zone function. Aberrant serum-induced ciliary resorption and cold-induced depolymerization in both ARMC9 and TOGARAM1 patient cells lines suggest a role for this new JBTS-associated protein complex in ciliary stability.part by the transition zone (TZ) that connects the axoneme to the membrane and acts as a partition.Approximately half of the known JBTS proteins, including RPGRIP1L (JBTS7) (14) and CC2D2A (JBTS9) (15), assemble into multi-protein complexes at the ciliary TZ where they are thought to organize the molecular gate that regulates ciliary protein entry and exit (16); and dysfunction of TZ organization is thought to play a key role in JBTS. Another subset of JBTS-associated proteins, including ARL13B (JBTS8) and INPP5E (JBTS1) (6), associate with the ciliary membrane beyond the TZ. These proteins are thought to play a role in regulation of signaling pathways such as Hh signaling via maintenance of ciliary lipid composition (17, 18). Different JBTS-associated proteins have been found to function at the basal body or distal segment/tip (4). CSPP1 (JBTS 21) (19) and CEP104 (JBTS25) (20) were mainly detected at the centrosomes and ciliary basal bodies, however their exact molecular function, and how defects in these proteins lead to JBTS, are less well understood. CEP104 localizes to the ciliary tip during ciliogenesis, where it is required for structural integrity in the motile cilia of Chlamydomonas and Tetrahymena (21, 22). Mutations in the gene encoding the ciliary tip kinesin KIF7 (JBTS12) cause JBTS, which were linked to defects in tubulin acetylation and Hedgehog signaling (23).Recently, we identified mutations in the gene encoding armadillo repeat motif containing 9 (ARMC9) in individuals with JBTS (JBTS30). ARMC9 localizes to centrioles (27) and the proximal portion of the cilium (28) in mammalian cilia. ARMC9 transcript levels are upregulated with induction of ciliogenesis and armc9 dysfunction in zebrafish yields typical ciliopathy phenotypes (27). As ARMC9 has not been identified as a component of the ciliary JS-associated protein modules mentioned above, we here use ARMC9 as a bait in protein interaction screen...