Environmental stressors have been postulated to impact the course of Tourette Syndrome (TS), given their known influence on brain development and adult mental and physical health. In children with TS, environmental stressors predict tic and psychiatric symptom severity at two-year follow up. In adults with TS, childhood adversity is associated with worst-ever tic severity. However, the broader longitudinal impact of environmental stressors on adults with TS remains uncertain. Our Center is conducting a longitudinal study to determine the association of lifetime environmental stress exposure with adult TS phenotype. At baseline and two-year follow up, participants undergo assessment of tics, comorbid psychiatric symptoms, and quality of life, as well as adverse childhood events and lifetime acute and chronic stressors. Over 100 adults have completed baseline assessment and more than 35 have completed the two-year follow up assessment. The presentation will review preliminary baseline and two-year follow up results from this Vanderbilt study.