A positive family history of breast cancer is an established risk factor for the disease. In Israel, screening is recommended annually for high-risk women aged > or =40 years and biennially for average-risk women aged > or =50 years. The current study aimed to assess the effect of having a positive breast cancer family history on performing screening mammography in Israeli women. This study is a cross-sectional survey based on a random sample of the Israeli population, conducted in 2003. The study was carried out by means of telephone interviews that included questions on the use of preventive medical services. The current study population consists of 1605 Israeli women aged 40-74 years. A positive family history for breast cancer was reported by 153 (9.5%) of the participants. A mammogram in the previous year was reported by 43.1 and 24.7% of the positive and negative family history subgroups, respectively (P<0.0001). Rates increased with age. Among women with a positive family history, only being married was a significant correlate for a mammography in the previous year. Over 60% and around 55% of high-risk women aged 40-49 and > or =50 years, respectively, are inadequately screened for breast cancer. Screening rates are not optimal in the average-risk group as well.