The fetal hypothalamus-pituitary-adrenal (HPA) axis plays a critical role in fetal development and physiology in utero: appropriate function of the fetal HPA axis is critical for preparation of the fetus for birth and survival in postnatal life. Because of the critical importance of appropriate physiological regulation of HPA activity in postnatal life, there has been intense interest in the possibility that fetal or neonatal stressors can permanently "program" the axis to hyperrespond or hyporespond to stimuli. This is a review of the literature relevant to normal development and "programming" of the HPA axis.