Case studies of extremely gifted individuals often reveal unique patterns of intellectual precocity and associated abnormalities in development and behavior. This article begins with a review of current neurophysiological and neuroanatomical findings related to the gifted population. The bulk of scientific inquiries provide evidence of unique patterns of right prefrontal cortex and inferior frontal activation implicated in gifted intelligence, although additional studies suggest enhanced neural processing and cerebral bilateralism. Geschwind, Behan, and Galaburda (GBG) first hypothesized the possible neurodevelopmental factors that account for unique brain development. This article explores more recent findings taken from the prenatal exposure literature and offers a proposed model for explaining aberrant developmental forces that may be at work in precocious individuals. (Contains figure.)