Preterm birth (PTB) remains one of the leading causes of neonatal mortality and long-­term morbidity worldwide, with minimal progress being made in reducing its incidence, particularly in low-­resource settings. Preconception care is recognized as an effective strategy for PTB prevention; however, the fact that more than half of pregnancies globally are unplanned significantly limits opportunities for successful intervention. These Federation of Gynecology and Obstetrics good practice recommendations advocate shifting from pregnancy-­centered care to woman-­centered care and promote the integration of a baby-­centered assessment into preconception care. This approach allows for the early identification and management of modifiable risk factors for PTB across various domains, including medical, obstetric, nutritional, infectious, psychological, and socio-­environmental factors. The review emphasizes the importance of evidence-­based interventions during the preconception period and underscores the need for policy and advocacy initiatives to promote equitable access to preconception services.