Childhood abuse and neglect have profound and lasting neurobiological effects, significantly impacting brain development and increasing the risk of psychopathology. This review synthesizes neuroimaging findings in children and adults who experienced various forms of maltreatment, including physical, sexual, and emotional abuse, as well as neglect. Key findings indicate that maltreatment alters brain structures such as the hippocampus, amygdala, and prefrontal cortex, with specific effects on regions involved in emotional processing and stress response. Parental verbal abuse, witnessing domestic violence, and sexual abuse are associated with changes in brain regions that process aversive experiences, including the auditory, visual, and somatosensory cortices. Maltreatment is linked to morphological changes in the anterior cingulate, dorsal lateral prefrontal, and orbitofrontal cortex, corpus callosum, and adult hippocampus, as well as enhanced amygdala responses to emotional faces and reduced striatal responses to anticipated rewards. The review highlights that early deprivation and later abuse may have opposing effects on amygdala volume, and that structural and functional abnormalities initially attributed to psychiatric illness may be more directly caused by abuse. These brain changes are likely adaptive responses to facilitate survival and reproduction in adverse environments. However, their relationship to psychopathology is complex, as they are discernible in both susceptible and resilient individuals with maltreatment histories. The review also discusses the importance of the type and timing of exposure, gender differences, and the potential for resilience mechanisms to be a focus of future research. Key findings include reduced hippocampal volume in adults with maltreatment histories, with gender differences observed, and the role of early exposure in shaping brain development. The amygdala is also affected, with studies showing both reductions and increases in volume depending on the type and timing of maltreatment. The cerebral cortex, particularly the prefrontal cortex, shows altered development, with reductions in gray and white matter volume in maltreated individuals. These changes are associated with impaired decision-making, emotional regulation, and increased risk for addiction. The review emphasizes the need to consider childhood maltreatment as a confounding factor in psychiatric neuroimaging studies and highlights the importance of understanding the neurobiological basis of psychiatric disorders in the context of early adversity.Childhood abuse and neglect have profound and lasting neurobiological effects, significantly impacting brain development and increasing the risk of psychopathology. This review synthesizes neuroimaging findings in children and adults who experienced various forms of maltreatment, including physical, sexual, and emotional abuse, as well as neglect. Key findings indicate that maltreatment alters brain structures such as the hippocampus, amygdala, and prefrontal cortex, with specific effects on regions involved in emotional processing and stress response. Parental verbal abuse, witnessing domestic violence, and sexual abuse are associated with changes in brain regions that process aversive experiences, including the auditory, visual, and somatosensory cortices. Maltreatment is linked to morphological changes in the anterior cingulate, dorsal lateral prefrontal, and orbitofrontal cortex, corpus callosum, and adult hippocampus, as well as enhanced amygdala responses to emotional faces and reduced striatal responses to anticipated rewards. The review highlights that early deprivation and later abuse may have opposing effects on amygdala volume, and that structural and functional abnormalities initially attributed to psychiatric illness may be more directly caused by abuse. These brain changes are likely adaptive responses to facilitate survival and reproduction in adverse environments. However, their relationship to psychopathology is complex, as they are discernible in both susceptible and resilient individuals with maltreatment histories. The review also discusses the importance of the type and timing of exposure, gender differences, and the potential for resilience mechanisms to be a focus of future research. Key findings include reduced hippocampal volume in adults with maltreatment histories, with gender differences observed, and the role of early exposure in shaping brain development. The amygdala is also affected, with studies showing both reductions and increases in volume depending on the type and timing of maltreatment. The cerebral cortex, particularly the prefrontal cortex, shows altered development, with reductions in gray and white matter volume in maltreated individuals. These changes are associated with impaired decision-making, emotional regulation, and increased risk for addiction. The review emphasizes the need to consider childhood maltreatment as a confounding factor in psychiatric neuroimaging studies and highlights the importance of understanding the neurobiological basis of psychiatric disorders in the context of early adversity.