This study examined whether a greater self-reported problem severity at intake is associated with a greater likelihood of receiving related ancillary treatment services. The sample of 3,625 adult substance abuse treatment completers represents 162 outpatient and 41 short-term inpatient/residential programs located throughout Minnesota. Problem severity and receipt of ancillary services were assessed in medical, psychological, family/social, employment, financial, and legal domains. Across treatment setting and client gender, individuals with higher problem severity were significantly more likely to receive related ancillary services in the areas of medical services, psychotropic medication, family/relationship counseling, financial services, and legal services. For other services, the positive association between problem severity and receipt of related ancillary services held for some but not all groups defined by treatment setting or gender. Despite consistent relationships between service need and receipt, large gaps remain with respect to programs' responsiveness to client needs.