Member States have requested guidance from the World Health Organization on the effects and safety of the use of multiple micronutrient powders for point-of-use fortification of foods consumed by pregnant women. This guideline is intended to help Member States in their efforts to make evidence-informed decisions on the appropriate nutrition actions to improve the nutritional status of pregnant women. It will also support their efforts to achieve the Sustainable Development Goals, the global targets set by the Comprehensive implementation plan on maternal, infant and young child nutrition and the Global strategy for women’s, children’s, and adolescents’ health 2016–2030. The guideline is intended for a wide audience, including governments, nongovernmental organizations, healthcare workers, scientists and donors involved in the design and implementation of micronutrient programmes and antenatal care services and their integration into national and subnational public health strategies and programmes. This WHO guideline states that routine use of multiple micronutrient powders during pregnancy is not recommended as an alternative to standard iron and folic supplementation during pregnancy for improving maternal and infant health outcomes.