Assimptions about the prevalence of inbreeding in Appalachia have long been used to account for certain characteristics of the mountain people and their culture. Such premises continue to be accepted as valid explanations even though little quantitative evidence has ever been presented on the subject. Inbreeding has become part of the popular stereotyped image of Appalachia, and has even been used to imply that mountain people are inherently to blame for their disadvantage! political and economic situation. This article presents a less speculative view of consanguineous marriage in Appalachia, based on the author's fieldwork, in which rates of isonymy (marriage between persons with the same surname) were used to estimate levels of inbreeding in a remote four-county area of Eastern Kentucky over a 140-year time period. The findings, along with data from previous studies of marriage patterns in mountain communities, suggest that inbreeding levels in Appalachia do not seem extreme enough to justify labeling inbreeding as unique or particularly common to the region, when compared with those reported for populations elsewhere or at earlier periods in American history.