Cells inherit two centrioles, the older of which is uniquely capable of generating a cilium. We identified that three evolutionarily conserved proteins that underlie human ciliopathies, CEP90, MNR and OFD1, form a complex. This complex localized to both distal centrioles and centriolar satellites, proteinaceous granules surrounding centrioles. Cells and mice lacking CEP90 or MNR did not generate cilia, failed to assemble distal appendages, and did not transduce Hedgehog signals. Disrupting the satellite pools did not affect distal appendage assembly, indicating that it is the centriolar populations of MNR and CEP90 that are critical for ciliogenesis. CEP90 recruited the most proximal known distal appendage component, CEP83, to root distal appendages formation, an early step in ciliogenesis. In addition to distal appendage formation, MNR, but not CEP90, restricted centriolar length by recruiting OFD1. We conclude that a complex of disease-associated proteins, MNR, OFD1 and CEP90, acts at the distal centriole to support ciliogenesis by restraining centriole length and assembling distal appendages.