The cytokinesis-block micronucleus (CBMN) assay has since many years been applied for in vitro genotoxicity testing and biomonitoring of human populations. The standard in vitro/ex vivo micronucleus test is usually performed on human lymphocytes and has become a comprehensive method to assess genetic damage, cytostasis, and cytotoxicity. The predictive association between the frequency of micronuclei (MN) in cytokinesis-blocked lymphocytes and cancer risk has recently been demonstrated. MN frequencies can be influenced by inherited (or acquired) genetic polymorphisms (or mutations) in genes responsible for the metabolic activation, detoxification of clastogens, and for the fidelity of DNA replication. An important advantage of the CBMN assay is its ability to detect both clastogenic and aneugenic events by centromere and kinetochore identification and contributes to the high sensitivity of the method. The objective of the present chapter is to review the mechanisms of induction of micronuclei, the method of the micronucleus assay and its combination with centromeric labeling in the FISH technique. Furthermore, an overview is given of recent results obtained by our laboratory by the application of the micronucleus assay.