Pretravel consultation before international adoption must encompass standard advice for those who travel, advice for those who are exposed to the newly adopted child, and information about caring for a new child during travel. Children who travel to meet siblings may need special accommodations before and during travel. Data on the health of internationally adopted children illustrate the risk of exposing family members and close contacts to some infectious diseases during or after international adoption. Parents, family members, and close contacts of the newly adopted child should be given advice to reduce their own and their child's risk. Targeted preadoption counseling, close attention to hygiene and safety advice, and prompt identification and treatment of infections lead to the safest and most trouble-free adoption travel experience.