Background/Aims: Thalassemia is one of the most common hereditary disorders in Turkey. The aim of our study was to determine the prevalence of the beta-thalassemia trait and abnormal hemoglobin in couples who applied for premarital screening in the third largest Turkish province of Izmir in the Aegean region. Methods: From January 2011 to March 2012, we tested 19,277 couples at the Karsiyaka Public Health Laboratory, Thalassemia Unit for the beta-thalassemia trait and abnormal hemoglobin using a high-performance liquid chromatograph, a hematology analyzer. Results: The beta-thalassemia trait with increased HbA(2) (>3.5%) and abnormal hemoglobin was found in 4.96% (1912/38,554) and 0.53% (206/38,554) people, respectively. Of abnormal hemoglobin findings, HbS was determined in 128 people (0.33%), HbD in 50 (0.13%), HbE in 24 (0.06%), and HbC in four (0.01%). Furthermore, in 20 of the 19,277 couples (0.05%), both partners had the beta-thalassemia trait and were referred to counseling. Conclusion: The prevalence of the beta-thalassemia trait in the province of Izmir is high compared with other cities of Turkey. Izmir is a high-risk province for beta-thalassemia and sickle-cell anemia. Therefore, premarital screening is essential to prevent new hereditary hemoglobinopaties.