Genetic testing comes in many shapes and sizes. The decision to undergo genetic testing must involve consideration of the medical, psychosocial, and reproductive benefits and risks of testing. The evaluation of risks and benefits varies significantly both between and within families. Pediatricians should keep up with the rapid advances in genetic medicine and the myriad of tests that are being developed and marketed. They also need to be familiar with the psychosocial risks and benefits that these new tests generate for individuals, families and communities. In some situations, genetic testing is merely another diagnostic tool; in other situations, genetic testing offers information about the risks for future diseases. Pediatricians need to be knowledgeable about tests that are indicated clinically and their potential psychosocial implications to best serve children, adolescents, and their families.