This paper deals with the finite-time inverse optimal output regulation problem for a class of uncertain nonlinear systems that are subjected to an exosystem. The nonlinear systems not only contain external disturbances in the exosystem but also take the unknown nonlinear functions and unmeasured states into account. The output regulation problem is first converted into a stabilization problem through the internal model. Then, fuzzy logic systems (FLSs) are employed to approximate the unknown nonlinear functions. An auxiliary system is constructed and, based on the auxiliary system, a fuzzy state observer is designed to estimate the unmeasured states. Furthermore, a novel adaptive fuzzy finite-time inverse optimal output feedback controller and adaptive law are designed by combining backstepping technology, adaptive control technology, finite-time stability theory, and the inverse optimal control method. The control algorithm ensures that all the signals of the closed-loop system are semiglobally practical finite-time stable (SGPFS), so the newly well-defined cost function that is connected with the auxiliary system can be minimized. Finally, the validity of the approach is confirmed by virtue of the simulation results.