The combination of high COL19A1 expression levels and a faster disease progression can promote a shorter life expectancy in ALS patients, and therefore COL19A1 levels can be considered a reliable blood-derived biomarker in muscle biopsies and in blood to support the clinical practice and to be of help in future clinical trials, as well as a promising and novel therapeutic target in ALS. This evidence concerns the gene COL19A1 and amyotrophic lateral sclerosis.