© 2018 Neonatal Nurses Association Despite the alarming increase in the numbers of infants born with neonatal abstinence syndrome (NAS), little is known about the effect on the children past the age of four. Clinical findings associated with NAS are found in the literature to have a negative effect on neurodevelopmental health outcomes. The purpose of this review is to examine the current evidence regarding NAS and neurodevelopmental outcomes, identify gaps in the literature, and discuss the possible association between NAS symptoms and neurodevelopmental disorders. A comprehensive literature review of quantitative research and review articles identified human and animal studies to clarify the current knowledge on the long-term effects of opioid exposure and NAS on neurodevelopmental outcomes. The analysis found that infants exposed to opioids in utero are at risk for poorer neurodevelopmental outcomes in early childhood; however, there is a lack of empirical evidence on the effect of NAS as children age.