The objectives of this study were: to inform health professionals and women of childbearing age about the prevention of neural tube defects by folate; to recommend that all women of childbearing age increase their intake of folate; and to evaluate the effectiveness of the strategies used to achieve these aims. The study took place in Western Australia. The Folate and Neural Tube Defects Prevention Project is a health promotion project using written material, presentations and unpaid media. Surveys were carried out of general practitioners, child health nurses and women of childbearing age before the project began and 12 months later. The main outcome measures were: knowledge of folate and prevention of neural tube defects and exposure to and effectiveness of promotional material. Knowledge of folate and the prevention of neural tube defects increased amongst general practitioners and child health nurses, and most displayed the promotional material and made changes in their practice to promote an increased folate intake for women planning a pregnancy. In women of childbearing age, the knowledge of folate, of spina bifida, and of the association between the two, increased over the study period. Women who had seen the promotional pamphlet were over seven times more likely to know that increased folate helps prevent spina bifida. The Project has been effective in raising awareness amongst health professionals and women of the prevention of neural tube defects by folate. Further evaluation is needed to determine the extent to which folate intake has increased, and its effectiveness in reducing the birth prevalence of neutral tube defects.