Cocaine use in pregnancy has been associated with low birth weight. Large population-based studies suggest that 5 to 7% of pregnant women have used cocaine, with much higher rates in low income inner-city women. Among 140 births at our institution of cocaine-using women, we found a lower rate of low birth weight in those who received prenatal care compared with those without prenatal care: 33 of 96 (34.3%) versus 23 of 44 (52.3%), P < .05. A review of the literature shows that comprehensive care, which includes both prenatal care and drug treatment, seems to be associated with better birth weight outcomes, particularly in women who stop their use in the first trimester. Prenatal care alone, however, is also associated with improved outcomes even if not specialized or linked to drug treatment.