Over thirty years of research has revealed that prenatal exposure to alcohol has a devastating impact on the structure and function of the developing central nervous system. Imaging studies over the past ten years have improved our understanding of the structural alterations related to prenatal alcohol exposure and provided researchers with potential hypotheses for brain-behavior relationships. Structural alterations associated with prenatal alcohol exposure have been found in overall brain size, shape, and symmetry, along with regional decreases in white and gray matter. In addition, abnormalities have been noted in specific structures such as the cerebellum, basal ganglia, and corpus callosum. This review demonstrates that specific areas of the brain may be more vulnerable to prenatal exposure to alcohol.