Objectives: To evaluate the impact of a decision aid for women considering genetic testing for breast/ovarian cancer risk given during genetic counseling. Methods: One hundred and forty-eight women were randomized to receive the decision aid or a control pamphlet at the beginning of their first consultation with a genetic counselor. When the patient received the decision aid, it was used to complement consultation discussions about genetic testing. One hundred and ten (74.3%) women completed the first questionnaire designed to elicit information about women's levels of decisional conflict and knowledge about genetic testing. Of these, 105 (70.9%) completed a second questionnaire to assess longer-term outcomes, 6 months postconsultation. Results: Results showed that women who received the decision aid felt more informed about genetic testing (χ2(1) = 8.69; P = 0.003), had clearer values (χ2(1) = 6.90; P = 0.009) and had higher knowledge levels (χ2(2) = 6.49; P = 0.039) than women who received the control pamphlet. Conclusions: The developed decision aid improved patient outcomes better than a control pamphlet when implemented during genetic counseling and given to the patient to take home.