Genetic testing is now an integral part of most areas of medicine, including Neurology. This article aims to guide clinicians on the pathways for genetic testing, including ethical dilemmas that can arise in the care of families with a confirmed or suspected genetic condition. The new UK National Health Service Genomic Medicine Service will alter the way genomic services are offered across the country. As genetics becomes mainstream, it is increasingly important for non-geneticists to keep abreast of developments, and be aware of potential pitfalls and when to seek specialist advice.