Consanguineous marriage (CM) or cousin marriage is a type of inter-familial union, defined as the marriage between two blood-related individuals who are second cousins or closer (inbreeding coefficient ⩾ 0.0156). Marriage is one of the important vital event and entry in to reproductive life in India. Prevalence and pattern of marriage varies across the states, regions and according to their religion and caste. Consanguineous marriages have been practiced since the early existence of humans. Consanguinity is the marriage between close relatives. Though consanguineous matings have cultural and socioeconomic advantages, their offspring have an increased risk for recessive disorders. The risk is not uniform in all cases and it varies based on several factors. Consanguinity is a deeply rooted social trend among one-fifth of the world population mostly residing in the Middle East, West Asia and North Africa, as well as among emigrants from these communities now residing in North America, Europe and Australia. The mounting public awareness on prevention of congenital and genetic disorders in offspring is driving an increasing number of couples contemplating marriage and reproduction in highly consanguineous communities to seek counseling on consanguinity. The article discusses the different type of measures that can be taken by a consanguineous couple before and after marriage to avoid genetic disorders in their progeny.