A microtubule-dependent motility process called intraflagellar transport (IFT) occurs beneath the plasma membrane of cilia and flagella. IFT was first observed in Chlamydomonas, and orthologs of some of the polypeptides involved in IFT have recently been identified in other organisms, including C. elegans and the mouse. In addition to a role in the assembly and maintenance of cilia and flagella, evidence is reviewed here that indicates defects in the process of IFT may be related to problems with human health. Moreover, recent data suggest the possibility of two new roles for IFT in cell function. The first is in transcriptional control of the genes encoding ciliary and flagellar proteins. IFT could provide a mechanism whereby the cell senses the presence or absence of its cilia or flagella and responds by turning on gene transcription resulting in replacement of the missing organelle. The second role is in signal transduction, whereby cilia act as sensors of the external cellular environment and transduce information about the surroundings into intracellular signals that are sent via IFT to the cell body, thus inducing an appropriate cellular response to the environment.