The ribosome translates the genetic code of a mRNA into a polypeptide chain, a fundamental cell function. The functional ribosome consists of two subunits, a 50S and a 30S. In the Mtb ribosome, the 50S subunit is composed of the 23S rRNA, 5S rRNA, and 35 proteins while the 30S subunit contains a 16S rRNA and 22 proteins. The 30S contains a messenger RNA decoding center and the 50S contains a peptidyl transferase center. The cryo-electron microscopy images of Mtb ribosome reveal species-specific structural features, such as extended or inserted rRNA helices and several significantly longer rProteins. The most striking of these is a unique 100-nt long expansion segment of the Mtb 23S rRNA, named H54a or the ‘handle’, is flexible and change its conformation upon joining of the large and small ribosomal subunits.