In June 2019, the UK Government took a step forward towards making a decision on the mandatory fortification of flour with folic acid (vitamin B9) in the prevention of neural tube defects (NTDs). It issued an open public consultation on the proposal in the form of a set of questions. The questions covered a range of issues including efficacy, safety, feasibility and cost. This review sets out the nine main questions and our answers. The aim is to present the rationale for mandatory fortification, what products should be fortified and the mean daily folic acid intake increase fortification should achieve across the population.