The role of the pharmacist in fetal alcohol spectrum disorder (FASD) involves prevention, counseling, and treatment. Regarding prevention, pharmacists should counsel women of childbearing age on contraception and the risks of alcohol use during pregnancy, as unplanned pregnancies are common and alcohol use is prevalent. When patients report lost or stolen medications, pharmacists should consider non-adherence due to diversion or misuse as well as the complex needs of those with FASD. Treatment of patients with FASD may involve psychostimulants, alpha-2 adrenergic agonists, or other medications to target symptoms like inattention and impulsivity.