Left-right asymmetry is an important aspect of human brain organization for functions including language and hand motor control, which can be altered in some psychiatric traits. The last five years have seen rapid advances in the identification of specific genes linked to variation in asymmetry of the human brain and/or handedness. These advances have been driven by a new generation of large-scale genome-wide association studies, carried out in samples ranging from roughly 16,000 to over 1.5 million participants. The implicated genes tend to be most active in the embryonic and fetal brain, consistent with early developmental patterning of brain asymmetry. Several of the genes encode components of microtubules, or other microtubule-associated proteins. Microtubules are key elements of the internal cellular skeleton (cytoskeleton). A major challenge remains to understand how these genes affect, or even induce, the brain’s left-right axis. Several of the implicated genes have also been associated with psychiatric or neurological disorders, and polygenic dispositions to autism and schizophrenia have been associated with structural brain asymmetry. Knowledge of developmental mechanisms that lead to hemispheric specialization may ultimately help to define etiologic subtypes of brain disorders.