The birth rates of neural tube defects (NTDs) vary between countries and regions and have shown marked changes following folic acid supplementation. This review is based on published data in international and local journals on the birth rates of NTDs in Arab countries and the available prevention programs. Among the 22 Arab states, published data on the birth rates of NTDs were retrieved from 13 countries. The rates varied from 0.62 to 13.8/1000 births. Variable rates were reported from the same country depending on the study methodology, year of study, and before and after folic acid supplementation. Twelve Arab countries fortify wheat with folic acid. This report shows major gaps in the epidemiological data related to NTDs in a number of Arab countries. It emphasizes the need to conduct standardized epidemiological surveys and collect data on the prevalence rates of NTDs to clarify the situation on the availability, extent, and quality of their prevention and care programs. Wheat fortification with folic acid is a feasible step addressing the primary prevention of NTDs.