An intensive case management intervention for homeless persons was evaluated by random assignment of 202 cases (involving 213 adults and 70 children) to the intervention or a control group. Full follow-up data (4 interviews: at baseline and at 6-, 12-, and 18-month follow-ups) were available on 98 cases (105 adults and 37 children). The follow-up rates for the 2 groups were not significantly different. Based on 13 repeated measures analyses, there were 3 statistically significant linear time effects (indicating overall change across the follow-up period) and 3 linear Time x Condition interactions (indicating differential change over time for intervention vs. control participants). Regardless of condition, adult participants improved in terms of their experience of homelessness, as well as on physical health symptoms and stressful life events. Condition x Time interactions indicating positive intervention impact were observed on the quality of housing environments, stressful life events, and interviewer ratings of psychopathology.