Background: Consanguinity, which is defined as marriage between close biological relatives (first and second cousins) is a deeply rooted cultural norm in India. Although socially acceptable in sore communities, it carries a genetic and health cost for children. Objectives: This paper investigates the prevalence and correlates of consanguinity in India, with particular reference to its socio-cultural patterning and health implications. Methods: A review of the published literature, of national survey data and regional interventions was undertaken to measure the prevalence of consanguinity, its social determinants and its genetic outcomes. Results: It is the aim of the current report to summarize what is currently known about consanguinity in India among Hindu and Muslim populations. While deemed desirable for social and economic reasons by families, offspring from consanguineous relations have a higher chance of congenital anomalies, hereditary diseases, and early death. Conclusion: The practice of consanguinity in Indian population is still turning on the wheel due to culture, religion, and financial reasons. Nevertheless, increased knowledge of genetic health hazards, prematrimony counselling, and expanded educational privilege are slowly bringing this to an end. Education and community-based interventions are needed to prevent negative health consequences while respecting local traditions.