Maternal use of alcohol during gestation is associated with FAS and less severe problems in exposed children, such as FAE and ARBD. This article reviewed the literature concerning the status of affected and exposed neonates and the available information on the developmental course of infants and children. Physical and behavioral characteristics of gestational alcohol exposure were described, and outcomes of retrospective and prospective research were reviewed. Currently, it is evident that heavy use and bingeing are associated with an increased risk to the offspring across a range of outcomes. Although the last 20 years of research in this area have provided a great deal of information, there remain unanswered questions regarding the course of the affected individual over the lifespan, the neuropsychologic status of children, and the relationship of prenatal exposure and the caregiving environment to the observed outcomes.