Amyotrophic lateral sclerosis is a hereditary disease that is directly inherited in a small percentage of families. If it is some adult onset amyotrophic lateral sclerosis patients, it is found in the clinic that most of them do not have a family history of the disease, generally there is only one isolated case in their family, this is the sporadic amyotrophic lateral sclerosis, although there may be a genetic tendency, but in we should not worry too much, because a family of sporadic amyotrophic lateral sclerosis patients are found not directly inherited. The rest of the small percentage of patients with amyotrophic lateral sclerosis are different and often have another family member with the disease, which is what we call familial amyotrophic lateral sclerosis. Familial amyotrophic lateral sclerosis, in terms of pathology, is most commonly inherited in the clinic in an autosomal dominant manner. Autosomal inheritance means that women or men are equally likely to inherit the genetic mutation of familial amyotrophic lateral sclerosis, because the gene that causes the disease has chromosomes in both men and women. The dominant genetic inheritance in the clinic mainly means that as long as the patient has an amyotrophic lateral sclerosis gene, then there will be mutations in the body afterwards and there will be a risk of developing amyotrophic lateral sclerosis. This means that the offspring of familial amyotrophic lateral sclerosis patients have a 50% chance of being inherited, and this 1 to 2 chance comes from the parents randomly inheriting a copy of their gene pair. In addition, if the patient’s children do not inherit the variant, they will not pass the disease on to their children. Currently, the best way to distinguish sporadic patients from familial patients in clinical practice is to ask for a family history. During diagnosis, neurologists will ask the patient if there is anyone else in the family who has had the disease, and most family history inquiries are very reliable in diagnosing the disease, because in most cases amyotrophic lateral sclerosis is not inherited.