At all stages of the existence of the state, one of its main tasks is the care and protection of the health of the people and the preservation of its gene pool. The solution to this problem is impossible without the direct participation of the state in creating a full-fledged and healthy family, as well as taking direct measures to prevent the birth of children with congenital diseases and diseases transmitted by inheritance, which is expressed in the legal regulation of medical examination of persons entering into marriage. We analyze the legislation of foreign countries. We state two approaches to regulating this issue, where some states adhere to the position that premarital medical examination is a right, not an obligation, while others hold the exact opposite opinion. We establish contradictions between the norms of family law and the norms of the family code with the norms of federal regulations. We identify the reasons for the lack of a mechanism for exercising the right to free medical examination of persons entering into marriage. Taking into account foreign legislation and on the basis of the identified problems of the implementation and protection of the right to free medical examination of persons entering into marriage, we propose amendments and additions to the Family Code of the Russian Federation.