This review is focused on adult hippocampal neurogenesis as a potential therapeutic target in fetal alcohol spectrum disorder (FASD). Adult hippocampal neurogenesis refers to the production of new hippocampal dentate granule cells (DGCs) from a replenishable pool of neural stem and progenitor cells throughout life. Adult-generated DGCs have been shown to exert a profound influence on hippocampal network activity in experimental animals and have been implicated in the regulation of many hippocampal-dependent behaviors and emotional states, including certain forms of learning and memory, anxiety, mood, and stress resilience. While adult hippocampal neurogenesis in humans remains controversial, many studies support its existence and impact on hippocampal function in human health and disease. Here, we review mechanisms of adult hippocampal neurogenesis under physiological conditions, as described primarily in rodent brain, its impact on network activity and behavior, and the negative effects of developmental alcohol exposure on this process. We then explore hippocampal neurogenesis as a potential target for FASD therapy using pharmacological and neurophysiological approaches known to stimulate adult hippocampal neurogenesis, currently available for clinical use in FASD patients.