Circumcision has been performed for at least 4,300 years. The oldest known depiction of the procedure dates to around 2300 BCE in ancient Egypt, making it one of the oldest surgical practices still in use today. What began as a cultural or religious ritual in a handful of ancient societies eventually spread across continents and, in the late 1800s, was repackaged as a medical procedure. Today, an estimated 37 to 39 percent of men worldwide are circumcised.
Ancient Origins in Egypt and the Near East
The earliest physical evidence of circumcision comes from Egyptian art and mummified remains. A carved relief dating to roughly 2300 BCE shows the procedure being performed, though some historians believe the practice is even older than its earliest surviving depiction. Ancient Egypt likely practiced circumcision as a marker of social status, ritual purity, or passage into adulthood, though the exact original purpose remains debated.
Other cultures across the ancient Near East, parts of sub-Saharan Africa, and Aboriginal Australia practiced circumcision independently. The reasons varied widely: some societies used it as an initiation rite for young men entering adulthood, others tied it to ideas about hygiene or fertility, and some viewed it as a sacrifice or offering. The fact that circumcision appeared in geographically separated cultures suggests it was likely invented multiple times rather than spreading from a single source.
How Circumcision Became a Religious Covenant
Judaism is the tradition most closely associated with circumcision as a religious obligation. The ceremony known as brit milah, performed on the eighth day after birth, is rooted in the biblical covenant between God and Abraham described in Genesis 17. However, the timeline of when this religious meaning was actually attached to the practice is more complex than it might seem.
Biblical scholars generally believe the idea of circumcision as a sign of a divine covenant did not emerge until the 6th century BCE, during the Babylonian Exile. Before that period, Jewish communities likely practiced circumcision but without the specific theological significance it later carried. The exile, which displaced the Jewish population from their homeland, appears to have been the catalyst for circumcision becoming a defining marker of Jewish identity, a way to distinguish the community from surrounding peoples.
Islam also practices circumcision, though the Quran does not explicitly command it. The tradition is rooted in the example of the Prophet Ibrahim (Abraham) and is considered a practice of fitrah, or natural disposition. Together, religious and cultural traditions account for roughly half of all circumcisions performed globally today.
The 19th Century Shift to Medicine
For most of recorded history, circumcision outside of religious communities was uncommon. That changed dramatically in the late 1800s, particularly in the United States and Britain. The germ theory of disease, which was revolutionizing medicine at the time, gave physicians a new lens through which to view the foreskin. The natural secretions produced beneath it were recast as infectious material, and removing the foreskin was framed as a way to cleanse the body of a potential harbor for germs.
Victorian-era doctors also promoted circumcision as a remedy for an extraordinary range of conditions, from epilepsy to behavioral problems, reflecting the moral anxieties of the period as much as any scientific evidence. Circumcision became closely tied to the broader medicalization of childbirth. For non-Jewish and non-Muslim families, having a son circumcised became a marker of a modern, physician-attended hospital delivery rather than a birth overseen by a midwife at home. By the early 20th century, routine newborn circumcision was standard practice in American hospitals.
Modern Tools and Techniques
Ancient circumcisions were performed with sharpened stone or metal blades, and the procedure remained relatively unchanged for millennia. The modern era introduced purpose-built surgical devices. The most widely used in the United States is the Gomco clamp, invented in Buffalo, New York, in the mid-20th century. Two other common devices, the Plastibell and the Mogen clamp, followed. All three work by controlling bleeding and protecting surrounding tissue, making the procedure faster and more standardized than earlier freehand methods.
In clinical settings today, complication rates for newborn circumcision are low. One large cohort study found minor complications, such as mild bleeding or swelling, occurred in about 3.8 percent of neonatal procedures. Major complications were rare, at roughly 0.3 percent.
Where Circumcision Stands Today
Global circumcision rates vary enormously by region. Prevalence is near-universal in predominantly Muslim countries and in Israel, while rates in most of Europe and East Asia are very low. The United States remains an outlier among Western nations, with circumcision rates that have hovered between 55 and 80 percent in recent decades depending on the region and population studied.
The American Academy of Pediatrics issued its most recent policy statement on circumcision in 2012, concluding that the health benefits of newborn circumcision outweigh the risks. However, the organization stopped short of recommending the procedure for all newborns, instead saying the benefits are sufficient to justify access for families who choose it and to support insurance coverage. That policy expired in 2017 and has not been formally updated, leaving the medical landscape in something of a gray zone.
What started as an ancient ritual carved into Egyptian stone has become one of the most common surgical procedures in the world, shaped at different points in history by religion, colonialism, germ theory, and evolving medical evidence. The practice today is less universal than it was at its peak in mid-20th-century America, but it remains deeply embedded in the cultural and medical fabric of dozens of countries.