Preconception care (PCC) and the first antenatal visit are crucial preventive strategies for maternal and child health. Based on the recommendations regarding preconception care and initial antenatal assessment presented in the 10th edition of the Guidelines for Preventive Activities in General Practice (Red Book) issued by the Royal Australian College of General Practitioners (RACGP), this review provided a comparative analysis of the models and practices of preconception care and first antenatal visit in China and Australia. The Australian model, centered on general practitioners (GPs), emphasized individualized services, including expanded carrier screening for genetic diseases and management of chronic diseases. In contrast, the Chinese model, driven by national public health projects and supported by the maternal and child health system, focused on group-based screening and management, implementing a "five-color" risk classification management system. Both models had their unique strengths. The Chinese model had achieved extensive service coverage and rapid improvement in key indicators, while the Australian model exceled in individualized and continuous services. Future directions for China could involve strengthening grassroots capacity and individualized services to provide higher quality, equitable, and humanized health services.