Maternal alcohol consumption during pregnancy can cause serious birth defects, of which fetal alcohol syndrome (FAS) is the most devastating. Recognizable by characteristic craniofacial abnormalities and growth deficiency, this condition includes severe alcohol-induced damage to the developing brain. FAS children experience deficits in intellectual functioning; difficulties in learning, memory, problem-solving, and attention; and difficulties with mental health and social interactions. An FAS diagnosis, however, fails to identify prenatal-alcohol-exposed children who lack the characteristic facial defects and growth deficiency of FAS. Nonetheless, these often undiagnosed children may still experience serious fetal alcohol effects (FAE), including alcohol-induced mental impairments (i.e., alcohol-related neurodevelopment disorder) or alcohol-related abnormalities of the skeleton and certain organ systems (i.e., alcohol-related birth defects). Neuroimaging techniques can assist researchers in identifying FAE through precise pictures of brain abnormalities in persons prenatally exposed to alcohol. By understanding the mechanisms underlying FAE and the behavioral manifestations of the resulting structural brain damage, researchers can ultimately develop effective FAS prevention strategies that identify and assist high-risk women at varying levels of pregnancy.