The global analysis of the published studies and reviews confirms the necessity of folic acid supplementation in women at the early stage of conception and until organogenesis during pregnancy, as the folate concentration is a critical factor that plays a fundamental role in the prevention of NTDs. Different strategies have been adopted, from promoting a diet rich in folate or a supplementation with folic acid tablets, which ensure better bioavailability compared with the natural one. Despite worldwide public health campaigns recommending periconceptional daily supplementation of folic acid, many women that are planning a pregnancy don’t follow these recommendations. In addition to that, about 40% of pregnancies are unplanned. Every efforts must be done to enhance the awareness of prevention among health institutions, medical communities and women of childbearing age.