The need to improve identification and understanding of individuals who have fetal alcohol spectrum disorder (FASD), including their strengths and challenges, is being increasingly recognized. Identification of FASD via screening is an important system-level intervention that may serve to improve early and accurate recognition of individuals who may have FASD, facilitate the provision of appropriately tailored support and interventions, and in doing so, foster healthy and positive outcomes for individuals and families. Effective and ethical implementation of FASD screening practices requires consideration of several factors for success, ensuring that resulting benefits outweigh potential harms. Using an implementation science framework, this topical review aims to provide an overview of these key considerations in order to guide further research and support practice and decision-making for service providers, organizations, and policy makers in the implementation of FASD identification and screening practices. These include prioritizing partnerships with stakeholders; taking a person-centered and ethical approach to FASD identification and screening; applying rigorous methodological research approaches to screening tool development, validation, and evaluation; increasing broader FASD awareness and response capacity at the system level; and advocating for continued policy reform and resources to enhance effective community-based support andinterventions following identification.