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To evaluate the effectiveness of the first phase of eight methadone maintenance treatment (MMT) clinics in China.Repeated cross-sectional surveys.Three surveys of clients attending the first phase of eight MMT clinics were carried out at entry, and 6 and 12 months after enrolment. Drug using behaviours, drug-related criminal activity, and relationships with families were compared for the three periods. Blood specimen were collected and tested for HIV for each client at entry, and HIV-negative clients were re-tested after 12 months.A total of 585, 609 and 468 clients participated in the first, second and third surveys, respectively. The proportion of clients who injected drugs reduced from 69.1 to 8.9 and 8.8%, and the frequency of injection in the past month had reduced from 90 times per month to twice per month, employment increased from 22.9 to 43.2 and 40.6%, and self-reported criminal behaviours reduced from 20.7 to 3.6 and 3.8% in the three surveys. By the third survey, 65.8% of clients reported a harmonious relationship with families, an increase from 46.8% at entry, and 95.9% of clients were satisfied with MMT services. Eight HIV seroconversions were found among 1153 clients during 12 months.The study demonstrated that the first phase MMT contributed to a reduction in drug use, drug injecting behaviours, drug-related criminal behaviours, HIV infections, and improved relationships within families among heroin users who participated in the MMT programme. MMT needs to be scaled up nationwide rapidly with improved services.