This review focuses on the fetal origins of adult disease hypothesis put forward by David Barker and his colleagues, recent advances in epidemiological studies and experimental research in this field. Barker Hypothesis states that environmental factors, particularly intrauterine nutrition, as indicated by birth weight, operate in early life to program the risks for adverse health outcomes in adult life. A large growing body of reports described the association between the early development and adult diseases, such as diabetes, hypertension, coronary heart disease, abnormal lipids metabolism, obesity and cancer, etc. Experimental studies show that the changes of some key genes' expression, caused by epigenetic modifications, lead to a permanent alteration of cellular proliferation and differentiation and finally the genesis in key tissues and organs. These results bring about the impairment in structures and functions and the increased susceptibility to chronic diseases in adult life. The hypothesis provides a new perspective for the prevention and therapy of chronic diseases.