The genotoxic effect of hookah smoke was investigated on somatic chromosomes of 35 occupationally nonexposed male hookah smokers. These were compared with an equal number of nonsmokers matched with respect to age, sex, drug intake, if any, and socio-economic status. The mitotic index (MI), chromosomal aberrations (CA), sister chromatid exchanges (SCE) and satellite associations (SA) were analysed. All the parameters showed a significant increase (p < 0.01) in the smokers compared with control individuals, viz MI, 3.88-5.41; CA, 0.94-2.22; SCE, 3.59-5.66; and SA, 5.2-8.65. A distinct time and dose effect relationship was observed. Hookah smoke is thus, both clastogenic and genotoxic for human beings.