Manifestation of diseases has been attributed to the genomic blue prints unique to individuals. This genome based horoscope has information right from susceptibilities towards disorders to drug responsiveness. These ailments can be single gene defects or polygenic and may involve subtle gene environment interactions. The plethora of diseases under the umbrella is increasing with new metabolic and life style disorders such as diabetes hypertension and cardiac complications gaining momentum. The orchestration mechanism and the key players of these are now being studied in light of molecular approaches and genomics collectively. This review is a humble attempt to outline and understand the spectrum of genetic diseases and discuss it in light of global issue in general and Indian perspective in particular.