Shut-down of translation is a global stress response required to block synthesis of proteins that cannot be correctly folded and thereby reduce the work load of the folding machinery, a primary target of the pathological process triggered by severe forms of stress. The short-term control of protein synthesis involves alterations in the activity of initiation factors mediated through changes in their phosphorylation states, the alpha subunit of eukaryotic initiation factor 2 being a key player in this process. While the stress-induced shut-down of translation is viewed as a protective response, the inability of vulnerable cells to restore protein synthesis after being exposed to a severe form of stress is a pathological process because it blocks the translation of messages coding for protective proteins required for restoration of function. In models of cerebral ischemia, prolonged suppression of protein synthesis is therefore always associated with extensive cell death. Endoplasmic reticulum (ER) dysfunction has been identified as the mechanism underlying ischemia-induced suppression of protein synthesis. GADD34 is a protein that plays a pivotal role in the recovery of cells from shut-down of translation induced by ER stress. After transient ischemia, a rise in GADD34 protein levels has been found in resistant but not in vulnerable cells. Knowledge of the mechanisms activated in resistant cells to restore protein synthesis after severe stress will help open up new avenues for therapeutic strategies to combat various disorders of the brain associated with impairment of the translational machinery.