Background: Even in adulthood, the disabilities associated with fetal alcohol spectrum disorders (FASD) may have a major impact on life, but different environmental circumstances during childhood may also be influential. This study aimed to investigate placements in out-of-home care, and number of early separations from caregivers, related to psychosocial outcomes in adults with fetal alcohol syndrome (FAS). Additional analyses were then done on a subgroup’s cognitive development and mental health. Methods: Data on education and living with biological parents or in out-of-home care were obtained from childhood medical records on 51 adults (43% women), mean age 32, all diagnosed with FAS. Adult psychosocial outcomes (e.g. highest completed education, economic status, care due to alcohol or illicit drug abuse, mental health and conviction for crime) were obtained from national registers. Results: No significant within-group differences related to the adult psychosocial outcomes were found. Psychiatric disorders, psychotropic drug prescriptions and crime convictions were equally common, regardless of whether placement in care was early or late, or whether the participants had experienced few or many early separations. Conclusions: We suggest that the findings illustrate the heterogeneity among individuals with FASD. Welfare authorities’ decisions concerning special education and placement in out-of-home care should be tailored to each individual. Interventions from society are still needed for individuals with FAS over 22 years old.