Visual recognition memory testing in high-risk infants has been shown to have significant predictive ability for later cognitive deficits. This study evaluated cognition in infants exposed prenatally to illicit stimulant drugs compared with nonexposed controls with a standardized test of visual recognition, the Fagan Test of Infant Intelligence (FTII). Thirty-six healthy, full-term infants with prenatal exposure to cocaine and/or amphetamines and 26 infants with no drug exposures, matched for race and socioeconomic status, were tested. Average FTII scores were significantly lower and the percentage testing at risk significantly higher in the drug-exposed group (p < .01). Differences between groups were also noted in behaviors dealing with attention, distractibility, and activity level. These data support recent evidence from longitudinal studies showing that infants exposed to drugs prenatally may be at risk for later subtle neurological abnormalities and suggest these difficulties may be identifiable long before the children reach school age. J Dev Behav Pediatr 13:108–111, 1992.