Identification of fetal alcohol spectrum disorder (FASD) may help facilitate the provision of supports and services for those who need them. Screening has been proposed as an important step in recognizing those at risk of having FASD. The current review aimed to systematically review the literature on screening tools and approaches for the identification of FASD. The search yielded several promising screening tools that are presently available for use with children, adolescents, and adults across a range of settings. Several emerging approaches based on biomarkers associated with prenatal alcohol exposure were also identified in the review. Overall, the current findings suggest that evidence supporting the validity of screening tools and approaches across populations and settings remains limited. Continued research in this area is needed to ensure proper identification of individuals with FASD in order to promote better long-term outcomes. Considerations for the implementation of screening programs are also presented.