Purpose: The authors hypothesized that significant positive relationships would exist between early gesture use and later language attainments in children with fragile X syndrome (FXS), as has been reported in studies with other populations. Method: Participants were young children with FXS and limited expressive language (21 boys, 4 girls), divided into 2 subgroups based on the Childhood Autism Rating Scale (CARS; Schopler, Reichler, & Renner, 1988) scores. Data were collected when participants were about 2 years of age and again when they were about 5 years of age. Communication was assessed through the analysis of video samples obtained in the children's homes for both observation periods. Correlational analyses were completed between early prelinguistic communication and later verbal communication scores for all participants and for children with high (greater than 30) versus low (less than 30) scores on the CARS. Results: Although no significant relationships were found between prelinguistic gesture use and language outcomes for the group of children as a whole, significant negative correlations were found for the group of children who had high CARS scores. Conclusions: These outcomes did not support the authors' initial hypotheses. It was concluded that extensive use of developmentally early gestures by children with FXS who also have many symptoms of autism may not be a positive indicator of later language. (Contains 2 tables.)