We surveyed opinions and recommendations about perinatal anticonvulsant (AC) treatment among 166 neurologists (n = 88) and psychiatrists (n = 78) practicing in Massachusetts. They were similar in the recommendation of routinely informing patients of potential teratogenic risks of ACs and avoiding valproate during pregnancy. Neurologists were more likely to encourage pregnancy and nursing during AC-use than psychiatrists, and psychiatrist were more cautious regarding perinatal safety, citing potential neurobehavioral risks and complications of breastfeeding. These observations indicate substantial differences in opinions between psychiatrists and neurologists regarding AC use during pregnancy.