Background: ATRX is involved in genome maintenance. Results: Somatic ATRX knock-out cells displayed hypersensitivity to hydroxyurea (HU) and defects in checkpoint activation and replication restart. Conclusion: ATRX is required for replication stress tolerance, proper checkpoint activation, and replication restart at stalled replication forks. Significance: These results reveal an unanticipated role of ATRX in maintaining genomic stability upon replication stress.