Fibrillar collagens have a long triple helix in which glycine is in every third position for more than 1000 amino acids. The three chains of these molecules are assembled with speci¢city into several di¡erent molecules that have tissue-speci¢c distribution. Mutations that alter folding of either the carboxy-terminal globular peptides that direct chain association, or of the regions of the triple helix that are important for nucleation, or of the bulk of the triple helix, all result in identi¢able genetic disorders in which the phenotype re£ects the region of expression of the genes and their tissue-speci¢c distribution. Mutations that result in changed amino-acid sequences in any of these regions have di¡erent e¡ects on folding and may have di¡erent phenotypic outcomes. Substitution for glycine residues in the triple helical domains are among the most common e¡ects of mutations, and the nature of the substituting residue and its location in the chain contribute to the e¡ect on folding and also on the phenotype. More complex mutations, such as deletions or insertions of triple helix, also a¡ect folding, probably because of alterations in helical pitch along the triple helix. These mutations all interfere with the ability of these molecules to form the characteristic ¢brillar array in the extracellular matrix and many result in intracellular retention of abnormal molecules.