K orea has recorded a very low total fertility rate of 1.15 in 2009. Young Koreans tend to postpone their marriage, and as a result of late marriage, the average age of first pregnancy has been continuously increasing. Older married couples often produced multifetal pregnancies due to assisted reproduction. Elderly pregnancies and multifetal pregnancies contribute to high maternal/perinatal mortalities and morbidities. Basic maternal and child health services including prenatal, delivery, and postpartum care are covered under national health insurance in Korea. However, preconception care is not covered under national health insurance nor any other pre-ventive service program. Many developed countries including United States and academic societies have emphasized the importance of preconception care and have proposed guidelines on preconception care. No suggested guidelines for preconception care have been developed in Korea. Evidence-based guidelines on preconception care should be developed with the coope-ration of associated academic societies. In addition, the Korean government should develop a comprehensive plan for preventive services for women including preconception care.