Preconception care is designed to identify and modify risks to a woman’s health and pregnancy outcome through prevention and management strategies. Although routine, structured prepregnancy health promotion is generally unavailable, surveys of women of childbearing age and health care professionals have indicated that such programs would be welcomed and useful. This case-control study was performed to determine whether women who receive preconception care through a structured approach are healthier at the time of conception compared with women who planned their pregnancy but were not exposed to preconception care. The study women were those who attended the preconception care service and conceived, received maternity care, and gave birth at the authors’ institution. These women were matched 1:3 with control women who planned their pregnancy but did not use the preconception care service. Records were matched for prepregnancy body mass index (BMI), age, parity, prepregnancy smoking status, and number of prepregnancy health conditions. Women participated in a 45-minute consultation with a midwife who asked prescribed questions pertaining to reproductive, medical, surgical, social, and family histories; lifestyle; nutrition; home; and work and social hazards. Women were given advice and information on folic acid supplementation, vaccinations, healthy eating before and during pregnancy, exercise, smoking cessation, and safe levels of alcohol intake. The primary outcome of the study was the likelihood of being “healthy” at the time of maternity booking. Being “healthy” was defined as early pregnancy BMI of18.5 to 24.9 kg/m2; ceased/reduced smoking and alcohol consumption; received folate supplementation for 3 or more months before conception and for the first 3 months of pregnancy; vaccinated against influenza, pertussis, varicella, and hepatitis B; and consulted with a specialist regarding a preexisting health condition before conception, if applicable. Secondary outcomes were gestational age at birth, small or larger for gestational age, gestational diabetes, hypertensive disorders of pregnancy, fetal anomaly, and mode of birth. Of 407 women who attended the preconception care service, 56 subsequently conceived and had maternity care at 12 to 20 weeks’ gestation. The service attendees and control subjects were similar for baseline characteristics and in the proportion of women having recurrent miscarriages and requiring artificial reproductive technology to conceive. Pregnant women who attended preconception care were more likely to have received adequate folate before conception, to have been vaccinated against influenza and hepatitis B, to have consulted with a specialist to optimize a preexisting health condition, and to have a smaller increase in BMI during the 6 months before conception. Attendees were no more or less likely to have reduced/ceased smoking or alcohol consumption before conception. Preterm birth and hypertensive disorders of pregnancy were less common among attendees, and they gave birth almost 2 weeks later than did control subjects. No differences were found in the rates of small-or-larger-for-gestational-age babies, gestational diabetes, fetal anomalies, or mode of delivery. These results indicate that women who attend a preconception consultation are more likely to be healthy across several domains than women who plan their pregnancy but do not attend a preconception consultation. Larger studies are needed to substantiate these initial positive findings. These preliminary data provide some hope that comprehensive preconception care service may positively affect maternal and neonatal outcomes.