Folic acid (FA) supplementation effectively reduces the rates of children born with neural tube defects (NTDs). Currently, 42 nations practice mandatory FA fortification to combat NTD. In addition to NTD, FA fortification may also have salutary effects on the incidence of orofacial cleft birth defects and have secondary benefits in reducing serum homocysteine concentrations and stroke mortality. However, a recent note of caution has been raised concerning a possible negative effect of mandatory FA fortification on the incidence of colorectal cancer.