Single nucleotide polymorphism–based microarrays used in diagnostic laboratories for the detection of copy number alterations also provide data allowing for surveillance of the genome for regions of homozygosity. The finding of one (or more) long contiguous stretch of homozygosity (LCSH) in a constitutional (nonneoplastic) diagnostic setting can lead to the diagnosis of uniparental disomy involving an imprinted chromosome or homozygous single gene mutations. The focus of this review is to describe the analytical detection of LCSH, clinical implications of excessive homozygosity, and considerations for follow-up diagnostic testing.