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Preconception care is a form of preventive care and its implementation might improve general women's health as well as improving pregnancy outcome. Our aim was to survey the attitudes of Israeli gynecologists regarding preconception counseling.E mailed questionnaires were sent to gynecologists in an Israeli gynecology network. The questionnaire included two identical sets of questions; one was regarding the care of reproductive aged women who visit their gynecologist for various reasons and the second was regarding the care of women in their first prenatal visit. Answers were scored (from 3-always to 0-never), summed and compared using Chi-square and paired t tests.Mean score for the preconception set was significantly lower than the prenatal set 11.3 (62.7%) versus 16.9 (93.7%) respectively, P < 0.001. Folic acid supplementation and genetic screening tests were recommended to most women in 99 and 94% of first prenatal care visit compared to only 42 and 62% of women who were not pregnant (P < 0.001).Gynecologists fail to recognize proper opportunities for preconception care. Increased awareness and concrete guidelines concerning timing and content of preconception counseling might be helpful.