Nutrition in pregnancy is receiving increased emphasis with the reports of adverse effects of alcohol, tobacco, and drugs on the outcome of pregnancy. Numerous articles concerning nutrition in pregnancy have appeared in the lay press. Almost daily a new method of weight reduction appears as a panacea for a weight conscious public. Both the woman and her physician may be confused, since during the last 40 years women have been starved, told to eat no meat, to eat red meat, or to eat ad lib because there should be no limit on weight gain during pregnancy. Can the practitioner with little formal education in nutrition identify the woman likely to be nutritionally at risk? If identified what should they be counseled regarding weight gain in pregnancy? Reasons for the changes in attitude about nutrition in pregnancy are reviewed herein, and methods of identifying the woman nutritionally at risk are presented. The importance of grouping women into underweight, normal weight, and overweight categories and of making individualized weight gain recommendations are discussed.