Genetic epidemiology gives no priority to genes or environment in the search of disease causation. However, a major problem in this field is the disentangling of the effects of environment and genes. The study of subjects separated very early in life from their biologic parents and adopted by unrelated parents provide a strong tool for estimation of genetic and familial environmental influences. The degree to which the trait or disease frequency of the adoptees is similar to that seen among the biologic relatives is an indication of the strength of the genetic influence. Similarity to the adoptive relatives suggests influences of the family environment shared between them. Adoption studies of adult obesity show that it is genes, and not the family environment, that is responsible for the familial aggregation of obesity. A study of the mortality of adult adoptees and their biologic and adoptive parents indicates a genetic influence on the risk of premature death from all causes, from natural causes, infections, and cardio- and cerebrovascular conditions, and suggests familial environmental influences on death from the vascular causes and from cancer.