A retrospective survey was made for estimating the recurrence risk of neural tube defects (NTD) in 233 hospitals of China during the period from July 1990 to June 1993. A total of 2159 women who born a baby with NTD in this pregnancy were investigated. Among them, 674 had one or more previous births (total in 889 births) before this pregnancy. Of the 889 children, 61 had NTD. Thus the overall estimate recurrence risk of NTD is 6.86%. The estimate recurrence risk of NTD is correlated with the prevalence. The estimate recurrence risks are 3.70%, 4.50% and 8.32% in the low-, average and high-prevalence areas respectively. There is a high recurrence risk for the same defect (anencephaly of spina bifida or encephalocele) of the index case.