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Use of simulation-based education (SBE) in social work is growing. However, there is a lack of substance use training, for both post-qualified social workers and undergraduate social work students. This study addressed a gap in undergraduate substance use education around prenatal alcohol exposure (PAE) and its impact on foetal development. A mixed methods approach was used with undergraduate social work students across two universities in the Southwest of the UK. Both groups received a taught session on foetal alcohol syndrome (FAS), completed pre- and post-taught session questionnaires assessing FAS knowledge, and had the opportunity to interact with the FAS neonate simulator. Creative activities around interaction with the FAS simulator enabled feedback on thoughts, feelings and practice implications. Findings revealed increased pre- to post-FAS knowledge and enhanced understanding of the long-term impacts of gestational alcohol use for the developing child. Social work students felt more aware of the impact of alcohol use during pregnancy and were more confident to address these issues through future practice. The use of FAS neonate simulators as a pedagogic tool is beneficial to help elucidate student knowledge on alcohol use during pregnancy and to increase confidence working with people who are pregnant who may be using alcohol or substances. [ABSTRACT FROM AUTHOR]