No, you do not need a blood test to get married anywhere in the United States. Every state has repealed its premarital blood test requirement. Montana was the last to do so in 2019, when its legislature ended a rubella screening requirement for women applying for a marriage license. Walk into any county clerk’s office today and the lab work is not on the checklist.
Why States Ever Asked for One
Starting in the late 1930s, states began requiring marriage license applicants to show proof of a blood test confirming they did not have communicable syphilis. By the mid-1950s, all but eight states had some version of the rule. The idea was to catch infections before marriage so they could be treated, protecting the spouse and reducing the risk of congenital syphilis in any children.
Syphilis was the main target, but the requirement grew in some places. Several states added rubella immunity screening for women under a certain age, because rubella contracted during pregnancy can cause serious birth defects. A smaller number screened for genetic conditions like sickle cell trait.
Why the Requirement Disappeared
Repeal happened gradually. By 1990, fewer than 20 states still required any premarital blood testing, and the rest fell away through the 1990s and 2000s. The reasons were practical. Antibiotics had driven syphilis rates down sharply, the tests caught very few cases relative to the number administered, and couples who wanted to skip the hassle would cross a state line to apply somewhere without the rule. The public health payoff no longer justified the cost or the friction. Montana’s 2019 repeal closed out the era.
What a Marriage License Actually Requires Today
With the blood test gone, the paperwork at the clerk’s office is straightforward. Specifics vary by state and county, so confirm the details for your jurisdiction before you go.
Identification and Age
Both applicants need a valid government-issued photo ID: a driver’s license, passport, or state ID card. The minimum age to marry without additional approval is 18 in every state. More than half of states allow 16- and 17-year-olds to marry with parental consent, and some permit marriage younger with a court order, though recent years have brought a trend toward higher minimums and tighter exceptions.
Social Security Numbers
Most states ask for a Social Security number on the application, but no federal law requires one to get married. If you don’t have one, procedures vary. Many states let you write “not applicable” or leave the field blank and show a passport or other government ID instead. A few require an affidavit explaining why you don’t have a number. Call the county clerk’s office before your appointment so you know what to bring.
Proof of Any Prior Marriage Ending
If either applicant has been married before, bring a certified copy of the divorce decree, annulment order, or former spouse’s death certificate. Some clerks will want the date and location of the prior marriage’s end as well. Bigamy is illegal in every state, so this step is not optional.
Witnesses
About half of states require one or two adult witnesses at the ceremony to sign the marriage license. The other half don’t require any. Where witnesses are required, they generally must be 18 or older and cannot be one of the people getting married. This detail trips up couples planning a small elopement or courthouse ceremony, so check it in advance.
Waiting Periods, Fees, and How Long the License Lasts
Waiting Periods
Some states impose a mandatory wait between issuing the license and the ceremony. Where they exist, these waits usually run one to three days. Roughly half of states have no waiting period at all, so you can get the license and marry the same day. A handful of states waive the wait if you complete a premarital education course or get a judge’s approval.
Fees
Marriage license fees run from about $20 to $115, depending on the jurisdiction. They vary not just by state but sometimes by county within the same state. Some locations discount the fee for couples who complete a premarital counseling or education course. Most clerk’s offices take cash, and more and more accept cards.
License Expiration
Your license has a shelf life. Once issued, you have a limited window to hold the ceremony and return the signed document. That window is as short as 30 days in states like Delaware, Kentucky, and Louisiana and as long as a full year in Arizona, Nebraska, Nevada, and Wyoming. Sixty days is the most common. If the license expires unused, you reapply and pay again, so plan the timeline.
Voluntary Health Screenings Still Make Sense
The state no longer asks, but many couples choose to get screened before marriage anyway. Nothing from these tests goes to the county clerk, and nothing in the results affects your license. Common ones to discuss with a doctor:
- Genetic carrier testing for conditions like sickle cell disease, cystic fibrosis, or thalassemia. It matters most for family planning, since two carriers of the same condition face a higher chance of having an affected child.
- STI screening for HIV, hepatitis B and C, herpes, and other infections. Knowing your status protects both partners and allows earlier treatment if needed.
- General bloodwork, such as a basic metabolic panel and complete blood count, which can flag thyroid issues, anemia, and other conditions worth knowing about before starting a family.
These are personal health decisions, not legal requirements. The legal answer to the original question is simply no.