The Hong Kong Hospital Authority has newly introduced a new Down's syndrome screening algorithm that offers free-of-charge noninvasive prenatal testing (NIPT) to women who screen as high risk. In preparation for this publicfunded second tier NIPT service, the present study was conducted to retrospectively analyse women eligible for NIPT and to review the local literature. Methods: Our retrospective study included women screened as high risk for Down's syndrome (adjusted term risk ≥1:250) during the period of 1 January 2015 to 31 December 2016. We performed descriptive statistics and multivariable logistic regression to examine the factors associated with women's choice between NIPT and invasive testing. We also reviewed existing local literature about second tier NIPT. Results: The study included 525 women who screened positive: 67% chose NIPT; 31% chose invasive diagnostic tests; and 2% declined further testing. Our literature review showed that in nonresearch (self-financed NIPT) settings, NIPT uptake rates have been increasing since 2011. Nulliparity, first trimester status, higher education,