University Medical Center in Jacksonville initiated a screening program for maternal serum alphafetoprotein (MSAFP) in October 1987. Women with both high and low values were recalled for testing. During the first two years, neural tube and other birth defects including cystic hygroma and gastroschisis were detected. No chromosomal abnormalities were found. The program meets the recommendation of the American College of Obstetrics and Gynecology to offer MSAFP testing to all pregnant women. Pregnant women in other areas of Florida could receive services through similar programs.