The arrival of Zika virus in the Americas in recent years brought with it a dramatic increase in the rates of microcephaly in regions of Northeastern Brazil. It was from this region of the of the world that we began to understand that this flavivirus (once considered a less severe version of dengue) could have devastating consequences when the infection occurred in pregnant women who did not yet have immunity. We now understand that Zika Congenital Syndrome can have additional effects outside of the central nervous system, but its most lasting consequences are related to the brain infection in utero.