Early autopsy examinations of individuals with heavy prenatal alcohol exposure revealed brain abnormalities including microcephaly as well as anomalies of specific brain structures [6]. While informative, these autopsy studies often represented the most severe cases of prenatal alcohol exposure, limiting their generalizability. Numerous neuroimaging studies are now available describing the detrimental impact of prenatal alcohol exposure on the brain and several recent reviews are available (see [7-10]). This review provides an update, highlighting some of the more recent neuroimaging studies within the context of previous research. Tables 1 and 2 summarize the structural and functional research findings from 2011-present and additional supplementary tables (Tables 3-6) are provided online which outline the neuroimaging findings over the past four decades.