Objective:To study the knowledge, attitude and practice of pregnant women regarding periconceptional folic acid (FA) intake.Design:Questionnaire-based prospective study.Setting:Antenatal clinic of a District General Hospital.Subjects:Three-hundred pregnant women in an antenatal clinic.Results:Nearly all (298/300) had heard of FA. A majority (275/300, 91%) knew that FA could prevent neural tube defects, and married women (P <0.001), those with higher education (P <0.001), those of Social Classes 1–3 (P <0.01) and women over 30 years of age (P <0.05) were more likely to be thus aware. Knowledge about the correct timing of FA intake was seen in 76% and was more likely in those with higher education (P <0.001), married women (P <0.001) and women age over 30 years (P <0.05). Intake of FA in the periconceptional period was seen in 134/300 (44.6%) women and was most likely in the married, Social Classes 1–3, women with higher education (all P <0.001), non-smokers (P <0.01), women with a planned pregnancy and women aged 30 years and over (P <0.05).Conclusions:The knowledge of the correct timing of FA intake was present in only 76%. Less than half (44.6%) had taken FA in the periconceptional period, and this was far more common in the more ‘privileged’ classes. Low socio-economic status, age less than 30 years, lower educational status and unplanned pregnancy were high risk factors for not taking FA. The challenge to the medical profession for targeting this group cannot be over-emphasised.