The exact prevalence of children and youth with Fetal Alcohol Spectrum Disorder (FASD) who live in out-of-home care in Canada is unknown. The current study hypothesized that the prevalence of children living in out-of-home care in Canada with FASD is higher than the general population, resulting in a significant economic cost. Federal, provincial, and territorially reported statistics informed the estimated number of children who live in out-of-home care with FASD. The total cost per day of caring for a child or youth with FASD living in out-of-home care was calculated using an inflation calculator and drawing on findings of a previous Canadian study that estimated the financial cost by age group and gender. Findings indicated that the estimated number of children and youth living in out-of-home care with FASD in Canada ranged between 2,225 and 7,620, and the annual cost ranged between $57.9 and $198.3 million depending on the province/territory. The difficulties faced by these children and families should be considered, as well as the economic cost of FASD, when examining the issue of FASD and child welfare. The authors suggest that focusing attention on the needs of this population and prevention efforts will help reduce the incidence of FASD in Canada.