Growing evidence points to the role of epigenetic mechanisms, including DNA methylation, in substance use and addiction. We conducted a systematic review of 47 recent (2012)(2013)(2014)(2015) animal and human studies that investigate DNA methylation and substance use/exposure, spanning preconception to adulthood. The majority of extant studies (i) focused on exposure during adulthood, (ii) examined the effects of alcohol use, (iii) employed a candidate gene approach, and (iv) were cross-sectional. While studies generally support an association between substance use/exposure and DNA methylation and also suggest that developmental context and timing matter, a dearth of longitudinal data and low comparability across studies currently limits the conclusions that can be drawn. Future challenges and directions for the field are discussed.