National Health Screening Program of Korea for chronic diseases was started in 1980. During the last 20 years, the problems of the program has been discussed. The problems discusses were as follows: (1) The current guideline is based on weak rationale, without concrete evidence-based decisions (2), The goal of the screening program was not set based on evidence, and there has been no evaluation for the effectiveness of the program (3), the program consists of test items without the diseases (4), the program was run by separate municipalities, so it was not organized for the subjects, and finally (5), there has been no remarkable reduction in incidence or prevalence of the related diseases. To improve the program, there have been many efforts including new national screening program called 'National screening program for the transitional period' in 2007 and launching the National Health Screening Act in 2009. The brief history of the National Health Screening program of Korea was reviewed. The Goal of the National Screening program is to reduce the mortality and/or morbidity of the target disease. To achieve this goal, the basic aspects of the Program should be fulfilled. Proper Guidelines, high screening uptake rate, high quality, appropriate follow-up program were discussed. And national screening programs are not so commonly provided internationally. Only Japan provide national health screening program and Japanese program was renovated in 2008. The aim, contents and the procedure of the Japanese program was reviewed. Finally, the aspects that should be discussed for the improvement of the national health screening program was listed.