BACKGROUND: Children with Fetal Alcohol Spectrum Disorders (FASD) are faced with a range of physical, cognitive, behavioral, and/or learning deficits, as well as poor executive functioning and social skills. Theory of mind (ToM) is the ability to understand that one's own perspective may differ from the perspective of another individual. ToM develops around age 4 and is correlated with performance on executive functioning tasks. OBJECTIVE: The goals of this study were to examine ToM performance in young children with FASD, how age was related to ToM performance, and whether ToM abilities were related to underlying executive function difficulties. METHOD: Fifty-three children (aged 4 to 8 years) participated: 25 children with FASD and 28 control children. All children were tested on measures of ToM, executive functioning, and receptive vocabulary. RESULTS: More children in the FASD group (44%) failed one or both ToM measures than in the control group (25%). Older children with FASD performed worse on ToM than younger children, but this was not the case for the control group. For the FASD group, ToM performance was correlated with a measure of inhibition, but for the control group, ToM was correlated with visual-spatial working memory. CONCLUSIONS: Children with FASD have difficulty on ToM tasks, and this difficulty may be related to underlying deficits in inhibition.