Background: While so much resources and effort are directed towards solving the challenges of pregnant women so as to achieve safe health for mother and child, it seems that the maternal and child health index has recorded very little improvement despite all input. Not many have recognized that a vast majority of such challenges could have been prevented at preconception. Preconception care has remained unexplored in Nigeria.

Objective: To determine the awareness and acceptance rate of preconception care in Nigeria.

Methods: This is a cross sectional study among female undergraduates of Nnamdi Azikiwe University, Awka, Nigeria. A multi stage sampling technique was employed to select respondents from different faculties among whom a pre-tested self-administered questionnaire was distributed and the data analyzed using statistical package for social sciences version 20.0, for rates and 95%Confidence intervals (95%CIs).

Results: A total of 600 questionnaires were distributed with a response rate of 90.3% (542/600). The study showed a low awareness rate of 28.2% (95%CI=23.9-33.1%), but an acceptance rate of 53.1% (95%CI=47.2-56.4%), for preconception care. Electronic media was the most source of awareness while the benefit of improved maternal and child health was the main motivating factor behind acceptance of preconception care.

Conclusion: Preconception care still remains a relatively unknown aspect of maternal health services in Nigeria. Adequate awareness will bring significant improvement in its practice in Nigeria especially among female undergraduates.