Rules of the game are simple. Someone asks a what if based question (Star Trek related, ofcourse) and someone gives the serious or a funny answer. Star Trek related, ofcourse. Make sure to ask only what if based questions! I will delete every post that violates this simple rule. Answers don't have to be serious.
So, let's see how many players we can get here. I'll start:

Q: What if Picard had some hair?

A: His signature move would be to brush or play with his hair instead of tugging at his shirt.

Q: What if the Enterprise couldn't go into reverse, like the Star Trekkin' song?

A: Then the famous command "Full reverse" wouldn't have any sense, would it?

Q: What if there was a third Mirror Universe where everyone has different sex?

A: The Federation is so uptight, it would be sure to avoid that universe altogether.

Q: What if the Borg Queen and Captain Janeway had to fight each other in a gladiatorial arena?

A: Then Spock and Kirk wouldn't have to, CBS only allows one gladiatorial fight per series - including spinoffs

Q: What if Spock become the ultimate ruler of Romulus in the late 24th century?

A: Then the Federation would likely have a much easier time manipulating Romulans and Remans into a peaceful relationship where the Romulans and Remans became unknowing slaves to the Federation

Q: What if Q was determined to do nothing but good for everyone in the universe?

A: Universe would be a better place, but Q episodes would be boring.

Q: What if Enterprise wasn't canceled before seventh season?

A: Then we would have finally seen the glorious rise of the Romulan Star Empire and the embarrassing defeat of the Federation.

Q: What if Tribbles had been great warriors instead of cuddly little fluffy things?

A: Then the Klingon songs of the Great Tribble hunt would have been more glorious than we can possibly imagine.

Q: What if Data had a beard instead of Riker.

A: Then his face wouldn't have been as smooth as an android's behind.

Q: What if Worf's parents hadn't let him have a pet Targ?

A: Then he would probably have eaten the family dog.

Q: What if Geordi's VISOR had also given him X-Ray vision? (Superman style)

A: It did, and he was just too smart to tell anyone.

Q: What if Spock had really caught his head in a Mechanical Rice Picker (what Kirk said was actually true)?

A: Then Spock would likely have run away, and decided not to show himself, or risk being humiliated by those who knew that he HAD actually gotten his head stuck in a mechanical rice picker.

Q: What if the Borg finally succeeded in assimilating Earth?

A: Then they wouldn't bother telling us "Resistance is futile". In fact, we'd be saying it too!

Q: What if Q's powers could only make big, bright flashes of light?

A: Then the best he could do to the Federation would be annoy them, and simply get in their way.

Q: What if Q was stuck babysitting a lost species 8472 pilot?