This paper highlights gender peculiarities in the neuroscience of alcohol effects and draws attention to emerging problems due to simultaneous exposure to alcohol and environmental factors. All the available gender studies on alcohol show greater severity of alcohol-related damage, including brain damage, in females compared with males. The differences are due to physiological peculiarities that make women more vulnerable to the effects of alcohol. Today the trend to start consuming alcohol at a younger age, together with the growing number of women drinking excessively, is increasing the alcohol-related risks to women's health and justifying the need for better, gender-based studies of alcohol use and abuse. A further aspect to consider in this context is the risk of the occurrence of foetal alcohol spectrum disorders and foetal alcohol syndrome in the offspring of women who drink during pregnancy. Several lines of evidence indicate that prenatal ethanol exposure can influence cell proliferation and differentiation in the central nervous system, causing severe neurotoxicity and permanent birth defects.