Advances in genomics have enabled the development of polygenic scores (PGS), sometimes called polygenic risk scores, in the context of multifactorial traits and diseases such as height, cancer, cardiovascular disease, and mental illness. PGS are measures of an individual's genetic predisposition, as compared to other members of a population, for conditions which are in uenced by both genetic and environmental factors. In the context of multifactorial disease, there is signi cant interest in using such risk strati cation afforded through genomics to improve screening, contribute to diagnosis or prognosis, guide treatment, and inform research. Yet, many acknowledge the need to thoughtfully consider and address the ethical, legal, and social implications (ELSI) of PGS. To contribute to this effort, this paper reports on a narrative review of the literature, with the aim of identifying and categorizing ELSI relating to genetic risk prediction in the context of multifactorial disease which have been raised by scholars in the eld. Ninety-two articles, spanning from 1977 to 2021, met inclusion criteria for this study. Identi ed ELSI were categorized into nine themes: potential bene ts; potential mis-or overinterpretation; the need for clear and accurate communication; potential for stigma and discrimination; potential con icts of interest and premature commercialization; need for standards and possible regulation; concerns about equitable access; need for diversity in research; and responsible data sharing. This research will support geneticists, clinicians, genetic counselors, patients, patient advocates, and policymakers in framing out and addressing ethical concerns associated with PGS; it will also guide future empirical and normative research.