Alternative pre-mRNA splicing is an integral part of gene regulation in eukaryotes. Here we provide a basic overview of the various types of alternative splicing, as well as the functional role, highlighting how alternative splicing varies across phylogeny. Regulated alternative splicing can affect protein function and ultimately impact biological outcomes. We examine the possibility that portions of alternatively spliced transcripts are the result of stochastic processes rather than regulated. We discuss the implications of misregulated alternative splicing and explore of the role of alternative splicing in human disease.