Below we will review current brain imaging literature defining alterations in the structure of the Central Nervous System (CNS) of infants, children, and young adults following prenatal exposure to cocaine, methamphetamine, marijuana, alcohol, and tobacco. For each of these drugs we will introduce the topic with a discussion highlighting some of the mechanisms thought to underlie their neuro-teratogenic effects. Neither the discussion of the mechanism of action nor the review of imaging findings in offspring following such prenatal drug exposures is exhaustive, but rather are geared to provide insights to better educate both researchers studying and clinicians caring for such infants and children.