Background: Pre-marital screening (PMS) is a health promotion activity that helps to decrease the incidence of certain genetic disorders and sexually transmitted diseases. The nurse has an integral role in providing genetic services that include assessing genetic risk, providing information, discussing available testing options, and providing appropriate supportive counseling. Purpose: To assess the knowledge, perception and attitude of future couples towards premarital screening. Design: A descriptive cross-sectional design was utilized. Setting: The present study was conducted in the Qebly Maternal and Child Health (MCH) center in Shebin El-Kom city in Menoufia Governorate. Sample: A convenience sample of three hundred and sixty future couples was used. Instruments: Instrument I: a structured interviewing questionnaire. Instrument II: attitude of the studied future couples regarding premarital screening and genetic counseling. Results: The results of the present study revealed that approximately three-quarters of the studied future couples (73.3%) had heard about PMS, but approximately two-thirds of the studied future couples (69.40%) had inadequate knowledge about premarital screening. More than one-half of the studied future couples (50.80%) had a positive perception of premarital screening. Approximately two-thirds of the studied future couples (68.30%) had a positive attitude about premarital screening. There were a positive correlation and a highly statistically difference among the total knowledge score, the total attitude score and the total perception score of studied future couples regarding premarital screening. Conclusion: There was a positive perception and attitude toward premarital screening.There were a positive correlation among the total knowledge score, the total attitude score and the total perception score of studied future couples regarding premarital screening. Recommendations:knowledge of the community regarding premarital screening should be increased in collaboration with adequate religious support and government policy. The effect of education programs regarding premarital screening on university students' knowledge, perception, and attitude should be studied.