Language and communication are two areas of functioning that are largely understudied among youth with fetal alcohol spectrum disorders (FASD). The current study aimed to elucidate the profile of language (i.e., receptive, expressive) and communication (i.e., functional, social) abilities in adolescents with FASD and investigate the relationship of language to communication. Subjects aged 12-17 years with (alcohol-exposed [AE] = 31) and without (control [CON] = 29) prenatal alcohol exposure were included. Receptive and expressive language were measured by the Clinical Evaluation of Language Fundamentals – Fifth Edition (CELF-5). Parents completed the Children’s Communication Checklist – Second Edition (CCC-2) as a subjective measure of general language. Functional communication was measured by the Student Functional Assessment of Verbal Reasoning and Executive Strategies (S-FAVRES) and parents completed the Social Skills Improvement System (SSIS) to measure social communication. Multivariate analysis of variance determined the overall profile of language and communication and whether it differed between groups. Next, multiple regression analyses examined the relationship of cognitive domains (inhibition, working memory, attention) to receptive and expressive language. Finally, multigroup path analysis determined if the proposed mediated effects of language (receptive, expressive) on communication (functional, social) via cognitive domains (inhibition, working memory, attention) differed between groups. The AE group performed significantly lower than the CON group on receptive language and parent-report of general language while groups did not significantly differ on expressive language. Groups did not significantly differ in functional communication while social communication was rated as significantly lower in the AE group. All cognitive domains were significantly related to receptive language while attention and inhibition related to expressive language across groups. Expressive language significantly related to both functional and social communication while receptive language significantly related to functional communication only. Overall, no indirect relations via cognitive domains were significant. The results of this study provide important information regarding the relations between basic language abilities and higher-level communication skills of adolescents with FASD. Interventions targeting working memory, inhibition, and attention may improve language abilities, which in turn may improve communication skills. Ultimately, improving communication skills of youth with FASD may translate to better overall functioning in multiple settings.