This study examined the evolution of the Arkansas Center for Addictions Research, Education, and Services (AR-CARES) over a 5-year period and evaluated its impact on women and children. The program was designed to provide comprehensive substance use prevention and treatment services to low-income pregnant and parenting women and their children. The program changed significantly over this time, based upon input from clients and staff, as well as in response to changing community resources. The evaluation suggests that the program had an impact on the substance use of study participants, birth outcomes, and the growth and development of children.