Purpose: Expanded pan-ethnic carrier screening is an effective tool for the management of reproductive risk. However, growth in the number of conditions screened, in combination with increasingly more comprehensive test methodologies, can lead to the detection of genetic findings that may affect the health of the tested individual. The objective of this study was to investigate the frequency of pathogenic genotypes in a presumed healthy carrier screening cohort to facilitate broader discussions regarding disclosure of genetic information from carrier screening., Methods: A retrospective analysis of 73,755 targeted carrier screens was performed to identify individuals with pathogenic genotypes and heterozygous risk alleles., Results: In this study, we identified 79 individuals (0.11%) with pathogenic genotypes associated with moderate to profound autosomal recessive or X-linked conditions. In addition, 10 cases had chromosome X dosage abnormalities suggestive of a sex chromosome abnormality. Heterozygote risk alleles represented the majority of ancillary findings in this cohort, including 280 female carriers of FMR1 premutation alleles, 15 heterozygous females with pathogenic DMD variants, and 174 heterozygotes with pathogenic variants in genes that may confer increased risk for somatic malignancies in the heterozygous state., Conclusion: These data suggest that nearly 1% of individuals undergoing carrier screening will have a finding that may require clinical evaluation or surveillance., Competing Interests: Conflict of Interest J.R., L.S.R., W.X., Z.Z., H.Z., and N.L. are current employees of Labcorp Genetics, a commercial entity that receives compensation for performing genetic testing. Author Information Conceptualization: J.R., L.S.R., W.X., H.Z., Z.Z., N.L.; Data Curation: J.R., L.S.R., W.X., H.Z., Z.Z., N.L.; Formal Analysis: J.R.; Writing-original draft: J.R., L.S.R., W.X., H.Z., Z.Z., N.L.; Writing and editing: J.R., L.S.R., W.X., H.Z., Z.Z., N.L. Ethics Declaration All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Per the US Federal Policy for the Protection of Human Subjects, institutional review board exemption was applicable because of the de-identification of the presented data (45 CFR part 46.101(b)(4)). Informed consent for genetic testing was required of all individuals whose data were included in this study. The contents of this manuscript have been reviewed for compliance by the Labcorp Legal department and the Department of Science and Technology., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)