Fetal alcohol spectrum disorder is an “umbrella” term that describes the spectrum of ethanol teratogenesis in humans. At one end of the spectrum are the subset of individuals with fetal alcohol syndrome, and at the other end of the spectrum are those individuals with behavioral and cognitive deficits who exhibit minimal or no physical stigmata as a consequence of ethanol‐induced prenatal brain injury. It was not until the past 3 decades that the medical community was convinced of the devastating effects of excessive alcohol use in pregnancy on the children. Although the diagnosis of fetal alcohol syndrome and its spectrum is a medical diagnosis, its effects on society are far‐reaching. Fetal alcohol spectrum disorder is distinct from many genetic syndromes described in this book in that the disorder is potentially entirely preventable, and the diagnosis points toward two affected individuals: the drinking mother and the alcohol‐exposed child. Diagnosis, intervention, and prevention offer some of the greatest challenges to health care providers, families, and their communities. Multidisciplinary diagnostic teams are developing throughout North America and other parts of the world that provide accurate and comprehensive assessments and treatment options for affected individuals with this common disorder.