Background: The purpose of this study is to assess whether infants born of mothers who abuse inhalants during pregnancy are at risk for developing dysmorphic features. Several descriptive reports suggest that these infants are at risk for a physical phenotype similar to the Fetal Alcohol Syndrome (FAS). Since toluene is ototoxic, we also assessed these children for neurosensory hearing loss. Methods: Using a controlled blind design, 27 children, 3-6 years old, born of mothers who heavily abused inhalants during pregnancy and their 27 age and sex matched controls were assessed by a dysmorphologist. Alcohol intake during pregnancy was not an exclusion criterion. Age appropriate audiologic assessments were performed on all children. Results: Fifteen of the 27 children were exposed to both inhalants and alcohol in utero. In the experimental group 10/27 had dysmorphic features consistent with the FAS physical phenotype, 5/27 had minimal dysmorphic features without a recognizable pattern, 1/27 was dysmorphic(microcephaly and hypertelorism) and 11/27 were normal. All 10 children with the FAS phenotype had a positive history for maternal alcohol use. In the control group, 3/27 also had minimal dysmorphic features. There was no difference between both groups for the presence of minimal dysmorphic features(p>0.05, Fisher exact test). The likelihood of the FAS physical phenotype was greater in the experimental group (p<0.001, Fisher exact test). None of the experimental or control subjects had neurosensory hearing loss.Conclusion: Our data do not support the existence of a fetal solvent syndrome physical phenotype or a risk for neurosensory hearing loss in children born of women who abuse inhalants during pregnancy. The pattern of dysmorphic features in our patients is likely atributable to alcohol exposure in utero.