DOC and DOCX look like a minor naming variation, similar to JPG versus JPEG, but they're not the same situation at all — DOCX represents a genuine, structural change in how Word documents are stored, introduced with Word 2007. Understanding what actually changed explains most of the "why won't this old file open right" problems people run into with older Word documents.
DOC: the older binary format
DOC was Word's format from Word 97 through Word 2003, and it stores document data in a binary format — a compact but proprietary structure that isn't human-readable and requires specific software logic to parse correctly. Because it's proprietary and less standardized, DOC files can be more prone to compatibility quirks when opened in non-Microsoft software, and the format has some real limitations around file size and certain advanced features compared to what came after it.
DOCX: an XML-based structure
DOCX, introduced with Word 2007, is built on OOXML (Office Open XML) — a zipped bundle of XML files that store text, formatting, images, and structure in a documented, more standardized way. This isn't just a technical detail: because the format is openly documented rather than proprietary, it's more consistently readable across different software (not just Microsoft's own), tends to produce smaller files through better compression, and better supports modern features Word has added since 2007. This is also why a tool built to parse DOCX properly can preserve formatting more reliably than one working with the older binary DOC structure.
Why old DOC files sometimes cause problems today
Modern Word still opens DOC files, but some newer Word features simply don't have an equivalent in the older format, so certain elements can shift or simplify when an old DOC file is opened and saved in a modern Word version. Non-Microsoft word processors generally handle DOCX more reliably than the older DOC format, since DOCX's documented structure is easier to implement support for than DOC's proprietary binary layout. If you're regularly running into formatting quirks with an old DOC file, that's very often exactly why.
Should you convert old DOC files to DOCX?
For a document you still actively work with, converting to DOCX (simply by opening it in modern Word and saving in the new format) generally improves compatibility and reduces the odds of formatting drift going forward, since you're moving to the format Word itself is now built around. For an old archived document you're unlikely to touch again, converting isn't strictly necessary — but if you're about to share it, edit it, or need it to look consistent across different software, updating to DOCX first is worth the extra step.
If the actual goal is a document that looks identical no matter what opens it, PDF is a more reliable destination than either Word format — Word to PDF handles that conversion from either DOC or DOCX, preserving the layout as a fixed, universally viewable file.