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Sheway is a single-access comprehensive street-front service to pregnant and parenting women with a history of alcohol and/or drug abuse that is located in one of Canada's poorest neighbourhoods, the Downtown Eastside of Vancouver. This investigation assesses the concurrent health and social problems clients report upon entry into the program, service utilization, and the impact of services on neonate and infant well-being. Data were collected through the review of files from the 9 ½ years of the agency's service. Findings suggest that the clients' concurrent health and social problems have increased over the years of operation while indicators of infant health have either improved or maintained steady rates.