The consumption of alcohol is a pervasive aspect of Australian culture. This includes women of reproductive age, who recent statistics show are drinking, on average, 3.5 standard drinks per day. Given that 50% of pregnancies are unplanned, there is the potential for many women to unknowingly expose their early embryo to alcohol before their pregnancy has been detected. While most women change their drinking behaviour once they find out they are pregnant, 47% continue to drink alcohol, albeit at lower levels. Chronic high levels of alcohol during pregnancy have well-known teratogenic effects on the developing fetus, causing fetal alcohol syndrome, nervous system and brain defects. However, there is also emerging evidence from rodent models that low-moderate consumption of alcohol during pregnancy can be detrimental to other non-neurological aspects of offspring health, even if exposure is only around the time of conception. This more common scenario of exposure results in fetal growth restriction, placental changes and renal, cardiac and metabolic dysfunction in adult offspring, often in a sex-specific manner. Interestingly, kidney development is perturbed, resulting in reduced kidney weight and life-time nephron endowment. The ovaries, like the kidneys, develop prenatally in mammals, with the life-time supply of oocytes established and arrested in an immature state in primordial follicles. These form that individual’s ‘ovarian reserve’, with only a small number destined to grow and eventually capable of ovulating a mature oocyte that can be fertilised. Importantly, in humans, there appears to be a link between the initial ovarian reserve at birth and age at menopause. This presentation will summarise evidence supporting a potential role for prenatal alcohol exposure to impact on offspring ovarian reserve and reproductive health, including recent preliminary data from a rat model of periconceptional alcohol exposure. Given that many women now wait to have children later in life, it is critical to understand what impacts the initial establishment of oocyte number in the ovary.