Context.-Human neurodevelopmental consequences of exposure to methylmercury (MeHg) from eating fish remain a question of public health concern. Objective.-To study the association between MeHg exposure and the developmental outcomes of children in the Republic of Seychelles at 66 months of age. Design.-A prospective longitudinal cohort study. Participants.-A total of 711 of 779 cohort mother-child pairs initially enrolled in the Seychelles Child Development Study in 1989. Setting.-The Republic of Seychelles, an archipelago in the Indian Ocean where 85% of the population consumes ocean fish daily. Main Outcome Measures.-Prenatal and postnatal MeHg exposure and 6 age-appropriate neurodevelopmental tests: the McCarthy Scales of Children's Abilities, the Preschool Language Scale, the Woodcock-Johnson Applied Problems and Letter and Word Recognition Tests of Achievement, the Bender Gestalt test, and the Child Behavior Checklist. Results.-The mean maternal hair total mercury level was 6.8 ppm and the mean child hair total mercury level at age 66 months was 6.5 ppm. No adverse outcomes at 66 months were associated with either prenatal or postnatal MeHg exposure. Conclusion.-In the population studied, consumption of a diet high in ocean fish appears to pose no threat to developmental outcomes through 66 months of age.