Thalassemia is the commonest single gene disorder in Sri Lanka. Government sponsored palliative care accumulate caseload leading to escalation of the health budget. Therefore prevention has become mandatory. Lack of facilities for antenatal diagnosis and the legal sanctions of abortions kept the nation away from adopting the policy of terminating the affected pregnancies which is the wellestablished method of thalassemia prevention in many parts of the world. National thalassemia prevention program adopted a policy of “safe marriage” that is defined as a marriage where at least one of the partners in a couple is not a carrier for thalassemia. This survey was conducted to evaluate the outcomes of the project after one year. Results show very poor uptake in spite of free facilities available for screening and counseling and reasonable awareness about the concept among the public. More intensive monitoring and strengthening of education programs are recommended. Establishing and integrating the thalassemia prevention program in the excising health care delivery should be intensified while considering the need for implementing a compulsory screening and counseling program in the country.