Consanguineous marriages have been practiced for hundreds of years in many parts of the world. The rate of congenital malformations among the offspring is 2.5 times higher than that among the offspring of unrelated parents, mainly due to the expression of autosomal-recessive disorders, and hospitalization for these reasons causes a major financial burden. An increase in sterility and in the rates of abortion, stillbirths, perinatal losses and neonatal deaths has been reported by some authors but not by others. It is generally accepted that the advantages of consanguinity outweigh the disadvantages; however, strategies for reducing the burden require a unique approach as discussed in this article.