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Diversity in the 5\u2032 UTR can be created by alternative transcription start site (TSS) selection and alternative splicing. Alternative TSS directly impact the first exon length or alternative first exon usage, while alternative splicing further contributes to generating different 5\u2032 UTR isoforms by for example, cassette exons inclusion, intron retention, and alternative 5\u2032 or 3\u2032 splice sites. Alternative TSS and alternative splicing in the 5\u2032 UTR directly affect translation efficiency by generating different isoforms that may include or exclude regulatory sequence elements and secondary structures in the 5\u2032 UTR. Among the regulatory elements, 5\u2032 UTRs may harbor translation\u2010inhibitory upstream open reading frames (uORFs) as well as internal ribosome entry sites (IRESs), which are able to recruit the ribosome in a cap\u2010independent manner. Both uORF\u2010 and IRES\u2010mediated mechanisms contribute to target\u2010specific protein production, especially under stress conditions associated with an inhibition of global translation. 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