Introduction: Anticipatory guidance, an important function of well-child visits, is often brief and not tailored to parents' concerns. This targeted pilot trial evaluated a new method of anticipatory guidance. Methods: Using an experimental/control study design, we surveyed 137 parents and 31 physicians, comparing their responses to targeted anticipatory guidance (physician-provided education based on parents' concerns) versus usual anticipatory guidance (standard physician lecture on parenting, safety, and nutritional topics). Results: Overall, physicians appeared less satisfied than parents with the educational component of well-child visits, and they desired changes in the educational aspect of these visits. While physicians believed the targeted approach was easier, control group parents appeared more satisfied with usual anticipatory guidance. The number of anticipatory guidance topics covered in the control group was less than half of that covered in the experimental group. Conclusions: Our targeted method of anticipatory guidance during well-child visits covered more educational topics and resulted in visits that were easier for physicians, but less satisfactory for parents. Further research is needed to identify methods of anticipatory guidance that are effective and satisfactory for both parents and physicians.