Objective: To measure the knowledge, attitudes and practices of health professionals regarding fetal alcohol syndrome (FAS) and alcohol use during pregnancy. Method: A postal survey of a representative random sample of health professionals was conducted in Western Australia (WA) in 2002/03. 1,143 (79\%) of 1,443 eligible health professionals completed the survey (87 Aboriginal Health Workers, 286 allied health professionals, 537 community nurses, 170 general practitioners and 63 obstetricians). Results: Of 1, 143 health professionals, 12\% identified all four essential diagnostic features of FAS. Most (95\%) had never diagnosed FAS. Although 82\% believed that making a diagnosis of FAS might improve treatment plans and 85\% agreed FAS was preventable, 53\% said the diagnosis might be stigmatising. Only 2\% felt very prepared to deal with FAS and most wanted information for themselves and their Clients. Of the 659 health professionals caring for pregnant women, only 45\% routinely ask about alcohol use in pregnancy, only 25\% routinely provide information on the consequences of alcohol use in pregnancy and only 13\% provide advice consistent with NHMRC guidelines on alcohol consumption in pregnancy. Conclusion: Health professionals have identified the need for educational materials for themselves and their clients. Implications: FAS is likely to be under-ascertained in Australia due to a lack of knowledge of FAS by health professionals. Until this lack of knowledge is addressed, opportunities for diagnosis and prevention of FAS will be limited.