According to the association between increased micronuclei (MNi) level in reproductive age women and increased risk of congenital abnormalities, we aimed in this study to find the contribution of WTS to women's health in apparently healthy young cases by comparing the variability of MN values in water pipe smokers and non-smokers. Finding the associations between MNi levels and demographic, socioeconomic, reproductive, and lifestyle factors was the secondary scope of this study. This cross-sectional case-control study was performed on 30 premenopausal women (15 cases and 15 controls) who lived in Tehran, according to our inclusion criteria. The mean MN frequency among waterpipe smokers was 28.53± 7.462, whereas the same parameter in the control group was 6.53 + 3.24 (p= 0.001). Non-parametric tests revealed a significant association between MNi and frequency of waterpipe smoking (p = 0.001), age of starting waterpipe smoking (p = 0.003), concurrent use of alcoholic drinks (p= 0.004), and secondhand smoking (p =0.001). In the context of heavy environmental pollution in Tehran, significantly higher MNi frequencies and decreased genomic health in waterpipe smoker women in reproductive age may predispose them to an increased risk of harmful reproductive outcomes. These findings emerge from governmental and non-governmental biomonitoring programs in high-risk women to concern more on unhealthy lifestyles and environmental pollution. تفاصيل المقالة