Background: Premarital screening reduces the occurrence of specific illnesses and their social impact. It is one of the best ways to avoid genetic illnesses, congenital anomalies, and medical and psychological marriage issues. Increasing target population awareness, positive attitude, and satisfaction with premarital screening will boost programmer use and success. Objectives: To assess couples' knowledge and attitude about premarital screening at Al-Batool Teaching Hospital's premarital care clinic, identify factors affecting knowledge and attitude, and assess satisfaction with clinic services.

Method: A cross-section study was conducted in Diyala City, at Al-Batool Teaching Hospital, during the period from the 1st of January 2022 to the 30th of November, targeting all the couples attending premarital care clinic at Al-Batool Teaching Hospital, during this period. Results: In this study, 800 participants participated. The majority, 510 (63.8%) were 20-29 years old. Only 9 (1.1%) had a personal history of genetic illness, whereas 20 (2.5%) had a family history. 21.4% of 171 had good knowledge. 82.3% of 658 had a favourable attitude. 673 (84.1%) were satisfied.

Conclusion: Few study participants were knowledgeable. A positive attitude and pleasure were noted. Poor knowledge, attitude, and contentment were highest among females, younger than 30, rural inhabitants, those with less than intermediate education, and the jobless.