Children show different temperamental styles early in development. Whether temperament predicts who children become as adults and how early we can predict these outcomes have been long-standing questions of interest to the scientific and public community. The current study used rigorous methods to characterize an inhibited temperament by 14 mo of age in a cohort of infants and followed them for three decades. We provide the strongest and earliest evidence showing that infants with an inhibited temperament at 14 mo became introverted adults, with poorer functioning in some social and mental health domains. Also, brain activity underlying cognitive control in adolescence was associated with adult mental health. These findings highlight the lasting influence of early temperament on social-emotional development.