Elevated corticosterone levels to stress have been found in adult rats exposed prenatally to alcohol, but little is known about the effects of prenatal alcohol exposure on the cortisol response in humans. To date, one study has found that crack/cocaine was related to depressed newborn cortisol levels following a heel prick. In the present study saliva samples were obtained before and after a blood draw from 83 inner-city African American 13-month-old infants exposed prenatally to alcohol, cocaine, and other illicit drugs. Post-blood draw cortisol levels did not differ from basal levels in many of the infants, confirming recent studies indicating adaptation of the adrenocortical response to this type of stress at this age. Maternal depression and emergence of teeth were positively related to cortisol levels. Alcohol exposure was related to elevated basal levels, cocaine to lower basal levels. As predicted from animal findings, heavy alcohol exposure was related to elevated poststress cortisol levels.