Despite the wide body of animal and human adult literature, a surprisingly small number of empirical studies have examined how alcohol-related neurotoxic damage might occur in the developing human brain. Thus, we sought to address this by conducting a stringent, systematic review that examined the current body of peer-reviewed, empirical work. Specifically, we sought to investigate how active alcohol use (AU) may impact human adolescent brain structure (using magnetic resonance imaging, MRI) and function (using functional (f)MRI). Our aim was to develop an empirically-driven understanding of how alcohol use influences the developing human brain. This information is critical for developing more effective prevention and intervention efforts for alcohol-consuming young people.