Indexes are crucial to SQL Server performance. Having the right indexes might make the difference of day and night with your application performance – as I once talked here.
However, even having the right indexes is not everything. You have to keep them healthy. Indexes, as any other kinds of storage, is subjected to fragmentation. SQL Server works best if the index structure is compact and continuous, but with all of the inserts/updates/deletes, it’s inevitable to get fragmented. When the fragmentation grows, it starts affecting the performance of SQL Server: Instead of having to read just one page, it now have to read two, which increases both time and resource needed, and so on and so forth.