Fetal alcohol spectrum disorder (FASD) is a group of disorders that can occur when the fetus experiences intrauterine exposure to alcohol. Alcohol present in a developing fetus’s bloodstream can interfere with the development of the brain and other critical organs, structures, and physiological systems. This chapter discusses FASDs, and includes strategies for prevention including early identification of maternal alcohol use during pregnancy, appropriate screenings for both the mother and child, and interventions and treatments for the child throughout adolescence. Intercepting alcohol use during pregnancy should be a major goal for all healthcare professionals, including but not limited to adult primary healthcare providers, obstetricians, dentists, and pediatric primary care providers (P-PCPs), which includes pediatricians, pediatric and family nurse practitioners, and physician assistants. Primary prevention is key to eliminating the devastating effects on the developing fetus and the adverse outcomes the child experiences throughout their lifetime.