People with fetal alcohol spectrum disorder (FASD) often experience inadequate supports, which can lead to an increased risk of becoming involved in the criminal legal system (CLS). This study compared the needs of people with prenatal alcohol exposure (PAE)/FASD with and without CLS contact and examined patterns of intervention recommendations. Data was drawn from the Canadian National FASD Database and included 544 people with PAE/FASD (M age = 21.1, SD = 8.9, 69.1% male), matched on age, IQ, and sex, in CLS (n = 272) and non-CLS (n = 272) groups. Diagnosis of substance use disorder and school expulsion/suspension emerged as key independent predictors of CLS contact. Rates of recommendations for intervention were high among people with CLS contact, particularly in respect to mental/physical health and safety needs. Understanding these needs is critical for informing clinical and forensic practice, intervention planning, and developing and implementing evidence-informed responses.