The present study compared pregnant drug-dependent women reporting homelessness (n=117) or being domiciled (n=118) at treatment enrollment on initial psychosocial functioning and subsequent drug treatment outcome. Homeless pregnant women presented with greater drug use and medical problems, less social service income, and more family/social difficulties than domiciled women. Homeless women had greater rates of psychiatric problems including suicidality and higher rates of physical, emotional and sexual abuse than their domiciled counterparts. Treatment retention was poorer for homeless than domiciled pregnant women. Results suggest that treatment should address the housing needs of pregnant drug abusers as well as their related social and psychiatric problems.