Data regarding the prevalence and patterns of alcohol consumption among pregnant women in the Russian Federation is lacking. As part of a longitudinal pregnancy outcome study being conducted in the Moscow Region of Russia, in the 5-month period from January through May 2005, pregnant women in four prenatal care facilities were screened for self-reported alcohol consumption in the month around the time of conception and in the most recent month of pregnancy. Among the 413 respondents, 347 (85.0%) reported some alcohol consumption during one of the two time periods, and 193 (51.9%) of these drinking women reported some alcohol use in the most recent month. Of particular concern was the pattern of drinking, with 75 (20.2%) of drinking women reporting at least one episode of five or more drinks around the time of conception, and 153 (41.1%) of drinking women reporting at least one episode of three or four drinks during that same time period. Furthermore, this same pattern of heavier episodic drinking was reported by 18 (4.8%) and 39 (10.5%) of drinking women, respectively, in the most recent month in pregnancy before the screening interview. These data indicate that pregnant women in these areas of the Moscow Region present an important opportunity for education and intervention for alcohol-related birth outcomes.