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Genomic instability, characterized by increased rates of genetic mutations and chromosomal aberrations, is a fundamental feature of various diseases, particularly cancer. This article reviews the mechanisms underlying genomic instability, including defects in DNA repair, replication, and segregation processes. We discuss the roles of various genetic and environmental factors that contribute to genomic instability and its impact on cellular function and disease progression. Understanding these mechanisms is crucial for developing targeted therapies and improving diagnostic strategies. This review highlights the importance of genomic instability in disease etiology and the potential for therapeutic intervention.