The present study used evidence-based dentistry (EBD) to identify clinical studies that described the effects of alcohol on fetal craniofacial development and qualitatively analyze the results found via this systematic review. This systematic review followed the guidelines “Meta-analysis Of Observational Studies in Epidemiology” (MOOSE). As a research strategy, several medical and scientific platforms were chosen, in which studies were sought using keywords defined from medical subject headings (MeSH), following the criterion of choosing keywords that were most related to the proposed theme. A total of 278 studies (116 studies in humans and 162 studies in animals) were identified and, after screening and analysis based on the inclusion criteria, twenty-six observational studies in humans were chosen for the configuration of this systematic review. Studies have reported fetal alterations related to alcohol consumption by mothers such as in the head shape and size, thin upper lip, hypoplastic philtrumbone, short palpebral fissures, micrognathia, flat nasal bridge, among others. These were more often found in patients whose mothers were alcoholics or those who had ingested high doses of alcohol, especially during the first trimester of gestation. Based on the analysis of the results, the impact of maternal alcohol consumption on fetal craniofacial development was evidenced and, as such, these complications can be harmful to the quality of life of the patient, both in childhood and in adulthood, as well as leading to lifelong sequelae. The results also suggest that to avoid craniofacial anatomical abnormalities related to alcohol, the best course of action is to stop alcohol consumption completely or at least reduce it to a minimum level before conception.