Fragile X syndrome is the most common form of inherited mental retardation currently known, associated with a wide range of developmental disabilities in both males and females, caused by a large expansion of a (CGG)n repeat in the first exon of the FMR1 gene. Fragile X syndrome occurs in all racial and ethnic groups, and it is a condition of major epidemiological importance among mentally handicapped males. Therefore, this disease must be considered in the differential diagnosis of any child with developmental delay, mental retardation or learning disability. The fragile X syndrome is due to the shutdown of the FMR1 gene transcription, and the pathogenesis of this syndrome is a consequence of absence of the protein product of the FMR1 gene (FMRP). Since the great majority of fragile X patients have the same type of mutation in a specific location of the gene, molecular analysis is extremely accurate for diagnosis of the disease, and important for genetic counseling of family members. Others genetic disorders are also caused by expanded trinucleotide repeats.