The effect of consanguinity and inbreeding on spontaneous abortion is assessed with the help of data from a population-based study conducted in four squatter settlements of Karachi, Pakistan. The analysis is based on 4966 pregnancy records belonging to 873 women. Results of the multivariate analysis show that both consanguinity and inbreeding were independent risk factors for spontaneous abortion despite undertaking control for other biological and socio-demographic factors that could confound the association. The combination of fetal and parental inbreeding led to a greater likelihood of a pregnancy ending in spontaneous abortion than one generation of inbreeding alone.