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Satisfaction with treatment was examined in relation to treatment outcomes (i.e., tenure and relapse for opioid use) and client and treatment variables. The sample consisted of 590 methadone maintenance clients in 21 clinics in the Research Triangle Institute/Treatment Outcome Process Study data system. Analyses were performed on the total sample and on three groups of clinics classified in terms of relapse rate and tenure in treatment. Satisfaction data were limited to the period covering the first 3 months in treatment. Overall, almost all clients included stated that the treatment had helped them to some degree with their drug problem or that they were at least somewhat satisfied with treatment (i.e., as of the third month in treatment). About three-quarters of the clients felt that the treatment had helped them at least somewhat with “other nondrug problems.” There were differences across clinic groups on all three satisfaction measures. Treatment outcomes were only marginally related to measures of satisfaction early in treatment. In the total sample, a few client and treatment variables had statistically significant correlations with the satisfaction measures. When the clinic groups were considered separately, methadone dosage variables were the strongest correlates of satisfaction. Overall, the results suggested that treatment satisfaction measured early in treatment does not have strong direct effects on during-treatment outcomes, and that the other predictors in the framework would have only modest indirect effects on treatment tenure through these satisfaction measures.