〔Abstract〕 Objective To explore the application value of pre-pregnancy health education combined with pre-marital pre-pregnancy health examination in genetic counseling of eugenics. Methods A total of 700 couples (350 pairs) who underwent eugenics genetic counseling at the Qingyuan Qingxin District Maternal and Child Health Hospital from September 2021 to May 2022 were selected and randomly divided into a control group and an observation group, with 350 cases (175 pairs) in each group. The control group received pre pregnancy health education, while the observation group received pre pregnancy health education combined with pre marital eugenics health examination. The adverse mood, eugenic knowledge awareness rate, examination cooperation rate, adverse pregnancy outcome and newborn birth defect rate of the two groups were compared before and after the intervention. Results After intervention, the scores of Hamilton depression scale (HAMD) and Hamilton anxiety scale (HAMA) in the observation group were lower than those in the control group, and the differences were statistically significant (P < 0.05). The eugenics knowledge awareness rate and examination cooperation rate of couples in the observation group were higher than those in the control group, and the differences were statistically significant (P < 0.05). The incidence of adverse pregnancy outcomes and birth defects in the observation group were lower than those in the control group, and the differences were statistically significant (P < 0.05). Conclusion Through the implementation of pre-pregnancy health education combined with pre-marital pre-pregnancy health examination, it can regulate and improve the negative emotions of pregnant couples during pregnancy, improve the awareness rate of pregnant couples about eugenic knowledge and the cooperation degree of examination, prevent adverse pregnancy outcomes, reduce the birth defects of newborns, and contribute to good birth and good upbringing.