Despite being essential for health, choline is one of the most overlooked nutrients in clinical practice. Critical for methylation, cell membrane integrity, liver and gallbladder function, choline deficiency can have far-reaching consequences. This snapshot addresses a key clinical question: Why do some individuals thrive on minimum recommended intake while others develop deficiency symptoms despite adequate consumption? We'll examine how genetic variations in PEMT, CHDH, and BHMT impact choline synthesis, transport, and utilisation. You'll learn why women's choline requirements shift dramatically after menopause, which populations face elevated deficiency risk, and what the implications of suboptimal levels include. We'll demonstrate how to use nutrigenetics insights to accurately assess individual choline needs and how to develop targeted nutritional interventions to optimise long-term health outcomes.