Folic acid, also known as vitamin B9, is essential micronutrient. Maternal intake of folic acid before and during early pregnancy helps to prevent most cases of neural tube birth defects (NTD) (i.e., spina bifida and anencephaly), two serious and life-threatening birth defects. Mandatory folic acid fortification of commonly consumed foods is a proven beneficial, safe, and cost-effective public health intervention for primary prevention of NTDs. Over 70 countries worldwide implement mandatory fortification of staple foods such as wheat flour, maize flour, and rice with recommended levels of folic acid. Many countries with effective mandatory fortification of staple foods have reported significant increases in blood folate levels among women of reproductive age, and associated reductions in the prevalence of NTDs, reaching a base level of ~5 cases per 10,000 births. In May 2023, World Health Assembly passed a resolution (76.19) to accelerate efforts for prevention of NTDs through safe and effective fortification.