Ribosomes are molecular machines that translate the genome into protein. They consume a large amount of energy, linking ribosomes to cellular energy management. This is one facet of ribosome stress, which we describe as a two-way process. Ribosomes are regulated by stress signaling, such as energy status, but also sense stress and enact appropriate responses. Stress sensing starts at ribosomes synthesis, which is linked to cell fate by ribosome components and biogenesis factors. Importantly, the working ribosome also senses stress-inducing aberrations, and has mechanisms to reduce their likelihood. Finally, even ribosome degradation is a regulated part of the stress response.