There is strong evidence that the Pathways Housing First model can move homeless people with sustained experiences of living rough, with problematic drug and alcohol use, and with severe mental illness straight into ordinary housing, and successfully sustain them in that housing. However, three questions can be raised about what ‘Housing First’ is delivering in a wider sense. The first question centres on what is meant by ‘Housing First’ as an ethos and as a model of service delivery, as there can be a lack of clarity about what these services are delivering. The second question centres on the extent to which Housing First services can address the needs of ‘chronically homeless’ people that exist alongside a fundamental requirement for sustainable housing. The third question centres on the wider role of the Housing First model, and whether the policy and research focus on Housing First is overemphasising one aspect of the wider social problem of homelessness.