Fetal alcohol spectrum disorder is a complex brain-based developmental disability. Research on the experiences of children with Fetal Alcohol Spectrum Disorder (FASD) and their caregivers consistently highlights the difficulties and frequent exclusion they experience with the education system as one of the most stressful aspects of their lives. Previous studies have identified the need for more integrated approaches to support and learning for children with FASD that recognize the integral role of positive teacher-student relationships on student outcomes. A systematic review of existing research on the school experiences of children and youth with FASD and their teachers was conducted, and a critical iterative approach was used to interpret the data. Key findings are discussed, and important recommendations are made for researchers, policymakers, and educators to address the longstanding gaps in research and practice regarding the complex care and support needs of those with FASD from an anti-oppressive, destigmatized, and holistic framework.