Zika virus infection during pregnancy is known to be associated with microcephaly and brain damage in the child. The clinical features of these children at birth have been well characterized, and by following the children’s development, the course of congenital Zika syndrome (CZS) can be determined. In a new study by Adriana Melo and colleagues, motor function was assessed with the Gross Motor Function Measure (GMFM) in 59 children aged 5–29 months with CZS. The scores for 48 children placed them in level V of the Gross Motor Function Classification system, signifying severe motor impairment. Indeed, only four children could complete any tasks in the walking, running and jumping domains of the GMFM. A severe malformation of cortical development at birth was associated with a lower GMFM score, whereas a larger head circumference at birth and a higher per capita family income were associated with higher GMFM scores. These and other insights into the motor development of children with CSZ could form the basis of future therapeutic interventions.