ABSTRACT. We evaluated the influence of gene-gene interactions between VANGL1, FZD3, and FZD6 on the risk of neural tube defects (NTDs) in Han population in the north of China. Two single nucleotide polymorphisms (SNPs) (rs4839469 and rs34059106) within VANGL1, two SNPs (rs2241802 and rs28639533) within FZD3, and three SNPs (rs827528, rs3808553, and rs12549394) within FZD6 were genotyped in 135 NTD patients and 135 controls. The gene-gene 2 R.P. Zhang et al. Genetics and Molecular Research 15 (3): gmr.15039010 interactions between VANGL1, FZD3, and FZD6 were analyzed using multifactor dimensionality reduction (MDR) software. The distribution of genotypes of rs4 839 469 within VANGL1 and rs3 808 553 within FZD6 differed significantly difference between patients and controls (P < 0.05). MDR revealed significance in models with 2 SNPs (rs4839469 and rs3808553) (OR = 3.18, 95%CI = 1.85-5.44; χ 2 = 18.39, P < 0.0001), 3 SNPs (rs4839469, rs2241802, and rs3808553) (OR = 4.17, 95%CI = 2.43-7.14; χ 2 = 28.5, P < 0.0001), and 4 SNPs (rs4839469, rs2241802, rs827528, and rs3808553) (OR = 7.34, 95%CI = 3.98-13.54; χ 2 = 45.3, P < 0.0001). Gene-gene interaction between VANGL1, FZD3, and FZD6 may exist, which may increase the risk of NTDs. This work provides insight into the understanding of the etiology of NTDs.