EXHIBIT 23.1

Consent of Independent Registered Public Accounting Firm

We consent to the incorporation by reference in the Registration Statement (Form S-8 No. 333-128805) pertaining to the 2005 Stock Incentive Plan and 2001 Stock Incentive Plan of Genomic Health, Inc. and the shelf Registration Statement (Form S-3 No. 333-141946) of our reports dated March 12, 2009, with respect to the consolidated financial statements and schedule of Genomic Health, Inc, and the effectiveness of internal control over financial reporting of Genomic Health, Inc. included in this Annual Report (Form 10-K) for the year ended December 31, 2008.

/s/ Ernst & Young LLP

Palo Alto, California
March 12, 2009