To assess how Flemish general practitioners (GPs) are handling the first contraception consultation, we used standardized patients (SPs) as the best method to assess the performance of GPs in daily practice. Thirty GPs got a visit from one of the three SPs. Based on a validated checklist, the SPs scored the performance of GPs and they registered the circumstances and the duration of the consultation. Twenty-eight consultations were analyzed. General practitioners scored moderately on the content level of the consultation. Rarely, GPs asked about attitude regarding safe sex, took gynecological history or discussed contraindications. None of the GPs took a personal history to exclude pregnancy. The SPs received enough information about correct pill use, but there was minimal discussion on factors associated with pill intake and interactions with other medications. Few GPs (6/28) gave a prescription corresponding to the Flemish guidelines. The others were influenced by the pharmaceutical representatives. The girls felt, however, very satisfied with the consultation with the GPs.