The evolution of technological advances in genomic sequencing has enabled transformative change in nephrological practice. Clinicians now have the ability to sequence patients with a variety of renal conditions for a variety of reasons. Typically genomics has been used for diagnostic purposes where conventional tools are uninformative but also for the assessment of risk to relatives, particularly potential organ donors and also for family planning. Which test we use is dependent on what is available to us in our own practice. This lecture will build on the other talks in the session to discuss which patients would benefit from testing, the sequencing techniques available and their specific benefits and risks. In addition, it is important to understand what we cannot do at this time but what technology is on the horizon that might be available to us in clinical practice in the near future.