Preimplantation genetic testing (PGT) is increasingly used in assisted reproduction to detect genetic and chromosomal abnormalities in embryos. While its clinical applications are well established, limited data exist on public understanding and ethical attitudes toward PGT in Greece. Our objective was to assess the knowledge and ethical perceptions of PGT among couples undergoing assisted reproductive technology (ART) in Greece and to identify factors associated with awareness, knowledge level, and ethical viewpoints.

A cross-sectional study was conducted at a private fertility clinic in Athens between December 2024 and November 2025. A structured, closed-ended questionnaire was completed anonymously by 110 participants (55 couples) undergoing ART. The survey assessed knowledge of miscarriage causes, awareness of PGT indications, and ethical attitudes toward embryo selection, savior sibling creation, and sex selection. Data were analyzed using descriptive statistics, chi-square tests, t-tests, and logistic regression models.

Most participants (91.8%) correctly identified chromosomal abnormalities as a cause of miscarriage. Awareness of PGT was moderate (56.4%), and only 41.8% recognized its indication for hereditary disease. A large majority (98.2%) supported the ethical acceptability of selecting healthy embryos, while only 7.3% approved of non-medical sex selection. High knowledge scores were significantly associated with PGT awareness [odds ratio (OR) = 4.13, p = 0.001] and more ethically conservative attitudes. Willingness to undergo PGT was predicted by awareness and belief in the ethical acceptability of embryo selection.

Greek ART patients show strong support for the therapeutic use of PGT but limited acceptance of enhancement-based applications. Knowledge and awareness significantly shape ethical perspectives, underscoring the need for targeted education and counseling.