Children of alcohol abusing parents (COAs) now receive more attention in their own right but data from methodologically sound studies is still thin. Genetic vulnerability increases risk of comorbidity for other psychiatric disorders and cognitive deficits as well as substance abuse. Neuropsychological effects of maternal alcohol consumption in pregnancy are more common than previously thought and paternal alcohol abuse may contribute to fetal damage. Family functioning is severely affected and COAs are at risk for child abuse though the strength of the association needs clarifying. Family drinking patterns are associated with teenage alcohol abuse and early induction increases the risk of addiction. COAs have raised morbidity rates for emotional and behavioural disturbance with impact on the developing child and separate prognostic significance for future adult morbidity other than alcoholism. Ethical considerations arise about the welfare of children cared for by alcohol abusing parents.