Exposure to drugs (both therapeutic and to substances of abuse such as opioids) during pregnancy are known to strongly associate with later adverse neurodevelopmental outcomes. However, little is known about how these exposures specifically affect the developing human brain and thus mechanistically how they result in later difficulties. Given emerging challenges such as the recent US opioid crisis, a clear need has emerged to better understand what underlies these difficulties so that difficulties can be identified early and to help develop possible treatments. In recent years, advances in neuroimaging methods and in particular Magnetic Resonance Imaging (MRI) have made it possible to gain images of the developing human brain during the critically important period shortly after birth and even in utero from the fetus. This can not only enable detailed visualisation of the brain’s evolving anatomy and help to identify possible injuries, but can also provide quantitative data about volumetric brain growth, tissue composition, and neurometabolite levels. Importantly, it can also provide entirely novel insight about how the brain’s framework of white matter pathways (structural connectivity) and coordinated activity (functional connectivity) emerge in early life. Importantly, disruptions to the establishment of this framework have also been found to significantly predict later adverse neurodevelopmental outcome. In this talk I will introduce these imaging methods, highlight the potential insight that they can provide into brain development and pathological processes, and review the existing literature in this area.