Birth defects represent a major public health concern affecting population quality and child health in China. Shifting the focus of prevention to the preconception period is a core strategy aligned with the "Healthy China 2030" initiative and the life-cycle health concept，and is also the most cost-effective and efficient measure for preventing birth defects. Preconception health management is not merely a preconception check-up but a systematic process encompassing health promotion，risk assessment，stratified intervention，and multi-disciplinary collaboration，serving as the most cost-effective primary prevention measure. Drawing upon the national policy requirements for constructing specialized preconception care units and the clinical practical experience of our hospital，this article elaborates on a systematic preconception health management framework involving comprehensive assessment，risk stratification，and precise intervention. It describes the core components and practical points in detail，and discusses current challenges and proposes countermeasures，envisioning a future shift from population-based prevention to individualized prevention and the establishment of a continuous，digitalized health management loop.