Recent advances in genetics and laboratory techniques have raised difficult issues for both the medical and lay communities. The desirability of initiating population screening programs is an example of one such issue that has engendered considerable confusion concerning is intent – so much so that the National Academy of Sciences recently reviewed this subject and in 1975 published a book entitled, Genetic Screening – Programs, Principles and Research. This presentation will describe the four major forms of population screening for genetic disease and, from the Virginia experience with some of them, demonstrate their strengths and shortcomings