With the aim of developing genetic tests for elevated and reduced radiation sensitivity, the authors studied the correlations between various genotypes and frequencies of spontaneous and radiation-induced chromosome aberrations in human lymphocytes. Cytogenetic analysis and genotyping (19 sites of detoxification and DNA repair genes) were carried out for a group of cleanup workers of the Chernobyl nuclear power plant accident (83 people) and for a uniform control group of volunteers (97 people). In both cases, the frequencies of chromosome type aberrations were higher in carriers of minor alleles of gene XPD [sites T2251G (Lys751Gln) and G862A (Asp312Asn)] and the "positive" genotypes GSTM1/GSTT1. The polymorphism of these genes did not affect the frequency of aberrations induced by gamma radiation in the control group (1 Gy in vitro), which was associated with genotypes by loci OGG1, XRCC1, and CYP1A1. Thus, in the control group, spontaneous and in vitro induced cytogenetic effects are associated with different groups of polymorphic genes. In the cleanup workers group (irradiated in vivo), the elevated frequency of aberrations was observed in the carriers of those genotypes that typically have a higher level of spontaneous (but not in vitro induced) cytogenetic damage in the control. The genotype "minor XPD + insertion GST," having an estimated incidence of 64% in central Russia, was characterized and found to be strongly associated with an elevated frequency of chromosome type aberrations following irradiation in vivo (OR = 6.9; p = 0.008).