This review focuses on the relationship between substance misuse and psychiatric disorder in women.Attention is drawn to their special, and heterogeneous, needs. Prevalence is discussed with reference to methodological difficulties in assessment. Some determinants of substance misuse are raised. The experiences and treatment needs of a sample of women attending substance misuse services are addressed with particular emphasis on the policy implications for mental health and substance misuse service providers in terms of innovative models of service delivery and systematic training initiatives.