Obstetrics complications are unpredictable. The pregnant woman is facing the environmental pollution, diet and lifestyle changes, infertility treatments, hormonal changes and stress. All the factors are affecting pregnancy and fetus. Preconceptional counselling is considered as the “Preventive Obstetrics”. It helps to minimize complications of pregnancy by changing the physical and mental status of couple willing for pregnancy. Ayurveda has mentioned preconceptional counselling starting from couple’s age for marriage, for conception and also mentioned the criteria for bridal selection. This article reviews the rationale for preconceptional counselling in Ayurveda, discusses practical possibilities of implementation of concepts in pre pregnancy period, and reveals some of the research topics which need a multi-centric trials to prove so as to redesign the program for reproductive healthcare.