The maternal and child health service in Thailand was originally established in 1918, and the first official maternal and child heath handbook was published in 1985. Since then, the handbook has been a major feature of the Thai MCH service and an important instrument for improving the health of pregnant women and children in Thailand. It has been periodically reviewed, revised and updated to maintain currency and to meet the ever changing and evolving health care needs of Thai women and children. This paper outlines the origins and history of this handbook. It comments briefly on its utilization which is still less widespread than expected, especially among clients of private health services. Future challenges are to promote use of the handbook through all types of health facilities throughout Thailand, so as to increase its utilization and further improve the quality of maternal and child health services.