Researchers and other public health professionals continue to debate the use of prevalence versus incidence as the preferred term to represent the frequency of birth defects. This paper addresses this question by noting that incidence—the number of new cases of a disorder in a given at-risk population during a specified time period—cannot be reliably estimated with existing data. Consequently, it is not appropriate to use the term “incidence” in reporting the frequency of birth defects, and the term prevalence is recommended. The basis for this recommendation, and issues involved in calculating both measures are discussed.