Fetal alcohol spectrum disorder (FASD) is the leading cause of developmental disability among Canadians. As a result, FASD has emerged as a public health priority in Canada. The current paper provides an overview of FASD in Canada with respect to (1) epidemiology; (2) conceptualizations of FASD by schools, the government, mental health services and the medical community; (3) current research; (4) prevention initiatives; and (5) intervention efforts. Overall, Canada has become a world leader in advancing knowledge about FASD, in part through the establishment of research networks aimed at preventing FASD and improving the lives of individuals affected by the disorder across the lifespan. A nationwide research framework has strengthened the links between research and practice in Canada, and major bodies in Canada appear to be moving towards a more integrated model for conceptualizing FASD, with increased investment in prevention and intervention. Although research and evaluation evidence is emerging, however, the strength of current evidence does not yet allow for prevalence rates or prevention and intervention best practices to be defined with certainty. With quality cross-sectoral research and evaluation that incorporates the lived experiences of parents and individuals with FASD, it will be possible to enhance understanding of facilitators and barriers to service delivery, access and utilization with respect to FASD prevention and intervention in Canada.