Roughly one in ten marriages globally involves first or second cousins. Pakistan has the highest rate at over 61%, followed by Kuwait and Qatar at around 54%. The practice clusters heavily across the Middle East, North Africa, and South Asia. National averages can be misleading though — in Turkey, rates vary dramatically from province to province, ranging from very high to very low depending on the region. We’ll explore why cousin marriage persists in certain areas, look at the economic and cultural factors behind it, and examine what genetics tells us about consanguinity and inherited conditions.