Chromosomal inversions have an important role in evolution, and an increasing number of inversion polymorphisms are being identified in the human population. The evolutionary history of these inversions and the mechanisms by which they arise are therefore of significant interest. Previously, a polymorphic inversion on human chromosome Xq28 that includes the FLNA and EMD loci was discovered and hypothesized to have been the result of nonallelic homologous recombination (NAHR) between near-identical inverted duplications flanking this region. Here, we carried out an in-depth study of the orthologous region in 27 additional eutherians and report that this inversion is not specific to humans, but has occurred independently and repeatedly at least 10 times in multiple eutherian lineages. Moreover, inverted duplications flank the FLNA-EMD region in all 16 species for which high-quality sequence assemblies are available. Based on detailed sequence analyses, we propose a model in which the observed inverted duplications originated from a common duplication event that predates the eutherian radiation. Subsequent gene conversion homogenized the duplications, thereby providing a continuous substrate for NAHR that led to the recurrent inversion of this segment of the genome. These results provide an extreme example in support of the evolutionary breakpoint reusage hypothesis and point out that some near-identical human segmental duplications may, in fact, have originated >100 million years ago.duplication ͉ gene conversion ͉ inversion polymorphism C hromosomal rearrangements were among the first types of genetic variation to be studied and have been proposed to play an important role in genome evolution and the phenotypic differences within and between species (1, 2). The recent availability of genomic data from multiple species has led to the unexpected discovery that structural variation, including inversions, is relatively common in the human population (3, 4), as well as between closely related species, such as human and chimpanzee (5-7). Comparisons of the positions of evolutionary breakpoints in different mammalian lineages suggest that a small fraction of the mammalian genome is particularly prone to rearrangement and constitute breakpoint ''hotspots'' that have been reused over the course of mammalian evolution (e.g., refs. 8 and 9). Therefore, a conserved property of mammalian genomes appears to be the presence of a limited number of fragile regions that commonly mediate chromosomal rearrangements. This observation contrasts with the long-held view that evolutionary breakpoints are distributed randomly across the genome (10), and there has been considerable debate pitting the random breakage model versus the fragile breakage/breakpoint reusage hypothesis (11).One mechanism known to mediate chromosomal rearrangements is nonallelic recombination between homologous sequences (NAHR). In humans, 5% of the genome is comprised of segmental duplications, which are typically defined as duplications Ͼ1 kb in length and Ͼ90% ...