Methamphetamine (meth) exposure during fetal development has the potential to adversely affect the development of multiple organ systems. An interdisciplinary case study of a 4-year 11-month-old child born to a mother addicted to meth revealed significant cognitive and communicative delays. Possible meth-related consequences for these delays included stroke in utero with associated hemiparesis and epilepsy, congenital eye dysfunction, recurrent middle ear infections, attention-deficit/hyperactivity disorder (ADHD), social adjustment problems, and parental neglect. An important additional finding was the child's nondietary iron deficiency anemia, which could contribute to or compound meth-related behavioral problems. The influence of chronic iron deficiency anemia on cognitive-communicative function speaks to the importance of including dietitians in the interdisciplinary team assessment of children exposed to meth. (Contains 4 tables.)