Studies show that many homeless women, who require treatment for substance abuse, do not receive it. This study identified social network and other predisposing factors associated with perceived need for and receipt of substance abuse treatment among 273 homeless women who screened positive for past-year substance abuse. Women with drug-using sex partners, a denser network, and an arrest history were more likely to have a perceived need for treatment. But, that perceived need was less likely for women with a child and a longer history of homelessness. Receiving treatment was more likely among women who received informational support from their sex partners and who had an arrest history but less likely among those who had a more street-based social network, had a young child, considered themselves homeless, and recently needed mental health treatment. To understand access and barriers to treatment, treatment services researchers should look more closely at social contextual factors and the more traditional individual factors.