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What does the appendix do? Biologists explain the complicated evolution of this inconvenient organ

The appendix evolved independently at least 32 times in mammals and supports immune functions by housing lymphoid tissue and sheltering beneficial gut microbes.

  • Biologists Phil Starks, Associate Professor of Biology, Tufts University, and Lilia Goncharova, Master's Candidate in Biology, Tufts University, published an explainer on The Conversation showing the appendix's evolution is more complex than a simple vestige.
  • Comparative studies show appendix-like organs evolved independently in marsupials, primates, and glires, with at least 32 separate origins indicating convergent evolution.
  • Containing gut-associated lymphoid tissue, the appendix is rich in lymphoid follicles in youth that expose immune cells to microbes and produce immunoglobulin A, while biofilms may shelter beneficial bacteria to repopulate the gut after infections.
  • Over the past century, improved sanitation and antibiotics have reduced diarrheal deaths, while modern surgery treats infected appendices by removal, making the organ a medical liability today.
  • Clinical evidence indicates several large fertility studies found no decrease after appendectomy, while evolutionary medicine helps modern clinical practice tailor treatments to marginal ancestral traits.
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What does the appendix do? Biologists explain the complicated evolution of this inconvenient organ

Most people get acquainted with their appendix when it's inflamed and about to rupture. Sebastian Kaulitzki/Science Photo Library via Getty ImagesMost people know only two things about the appendix: You don’t need it – and if it bursts, you need surgery fast. That basic story traces back at least to Charles Darwin, the English naturalist who developed the theory of natural selection. In “The Descent of Man,” he described the appendix as a vestig…

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The Conversation broke the news in on Monday, March 9, 2026.
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