B3GLCT is an endoplasmic reticulum-resident β1,3-glucosyltransferase that operates within a substrate quality-control pathway for thrombospondin type 1 repeat (TSR)-containing proteins (PMID:28926587, PMID:31600785). It catalyzes transfer of glucose via a β1-3 linkage onto O-linked fucose attached to TSRs, acting sequentially after POFUT2 to complete a glucose-β1,3-fucose disaccharide on properly folded TSRs (PMID:28926587, PMID:31600785). This disaccharide stabilizes the TSR fold and promotes secretion of a specific subset of TSR-containing proteins: ADAMTS20 is highly dependent on B3GLCT, ADAMTS9 is partially dependent, and SCO-spondin (SSPO) requires the modification for efficient secretion, with loss causing intracellular accumulation and elevated BiP indicative of a folding/quality-control defect (PMID:31600785, PMID:33909046). The dependence is substrate-specific — thrombospondin 1 (TSP1) loses its glucose-fucose modification upon B3GLCT loss yet is secreted normally, with a compensatory increase in TSR C-mannosylation (PMID:34695439). Through this role, B3GLCT loss perturbs ADAMTS9/ADAMTS20-dependent ependymal cilia basal body organization and translational polarity (PMID:33909046). Biallelic truncating mutations in B3GLCT cause Peters Plus syndrome, a congenital disorder of glycosylation, including via splice mutations that trigger nonsense-mediated decay (PMID:16909395, PMID:23954224).