In contrast to a nationwide decline in the consumption of illegal drugs, an increased level of methamphetamine consumption was observed in the past few years in Saxony. Two thirds of these consumers are 20 to 30 years old and they show different consumption motives and access roads to the drug. Since one third of the consumers are young women, the effects of this drug load can be observed in obstetrics and pediatrics. The presented data refer to 145 children born from January 2007 to May 2016 with prenatal methamphetamine exposition and admission to a neonatal intensive care unit in a perinatal center level I. The mothers perceived the preventive medical examination late or not at all (15%) and reported to have quit the drug usage when they noticed their pregnancy. However, half of them were tested positive for methamphetamine at the time of delivery. There was an increased risk of preterm birth (29%) and intrauterine growth restriction (small for gestational age: 24%; microcephaly: 23%) in children. The typical symptoms of the neonatal abstinence syndrome could not be observed, which complicates the clinical evaluation of the child. The coordination of the detoxification treatment of the mother and at the same time the medical care for the newborn as well as the early inclusion of the local help systems increases the chance for a child to grow up in its family of origin.