A cross sectional study was conducted in 10 randomly selected PHC Centers in Baghdad city from 1st of January 2006 to the end of December 2006. A representative sample of six thousand fertile married women aged fifteen years and above was selected excluding widowed, divorced, infertile, and nulliparaus women. Selected women were interviewed for the aim of identifying consanguinity rate among families in Baghdad, identifying adverse pregnancy outcome among consanguineous couples, and the factors that are associated with consanguinity and adverse pregnancy outcome. Results demonstrate that the rate of consanguinity in Baghdad is 47.4%, 33.7% of them were with second degree of relation. Some independent variables were significantly associated with consanguinity as higher risk of having a child with stillbirth or offspring mortality and the second degree of consanguinity shows higher risk (1.49 times) of offspring mortality. The risk of having a child with congenital birth defect is 1.3 times higher among those with second degree of consanguinity. In the current study, those with second degree of consanguinity showing higher risk of having a child with congenital heart disease, and abnormalities of nervous system, while there was no statistical significant association between consanguinity and the risk of having a child with chromosomal disorder and urethral abnormalities. For the musculoskeletal abnormalities, there was a statistical significant association with the third degree of consanguinity. The risk of having stillbirth, perinatal, neonatal, under five years old mortality was positively statistically significantly associated with second degree of consanguinity as compared to unrelated group. The risk of abortion, premature child, and low birth weight child was lower among second degree of consanguinity than those with unrelated group. No important risk effect of consanguinity on post neonatal mortality. Multivariate analysis of factors associated with congenital anomalies, for maternal predictors model revealed that second degree of consanguinity, illiterate mothers, mother's with gravida seven and higher, and those with history of exposure to radiation were expected to increase the risk of congenital anomalies. For paternal predictors model; second degree of consanguinity, illiterate father, and higher parity group more than six were expected to increase the risk of congenital anomalies. Factors associated with offspring mortality, for maternal predictors' model revealed that second degree of consanguinity and increase in gravidity were positively associated with offspring mortality. Urban residence was considered as a protection against the risk of offspring mortality. The study concluded that consanguinity rate is relatively high in Iraq as compared to other parts of the world with a trend towards decrease in the endogamy, and that second degree of consanguinity were more frequent as compared to other types of kinship and that the risk of offspring mortality and some congenital anomalies are higher among the consanguineous couples. It is recommended that premarital genetic counseling is an important tool in the detection of genetic disorder and the reduction of their incidence among the offspring, there is an urgent need to establish an education program to increase awareness of the consanguineous mating and inform the public properly about the anticipated deleterious effect of inbreeding in societies where intermarriage is widely practiced.