Apart from single gene disorders, there are numerous complex disorder like infertility, cancer, metabolic disorders, neurological disorders, etc. where in more than one genes are involved. In these clinical manifestation advance genomic study is required to determine the genetic cause. There are two major approaches in genome based analysis Microarray and NGS. Both the approaches have their own benefits and limitation. Selection of the approach is always case to case basis, where clinician and geneticist have to jointly take a call on the approach.  Microarray has been vital in detecting microdeletion or duplication in prenatal cases and NGS has been beneficial in cases with established phenotype.