This study explores the influence of gender on changes in recovery status among participants in a longitudinal study. The study sample (N = 1,202; 60% female) is recruited on referral to treatment, and annual interviews are conducted from Years 2 to 6 following intake. At each annual observation, participants are classified into one of four statuses (recovery, treatment, incarcerated, and using), and the transitional probabilities and correlates of transitioning from one status to another are estimated. About 80% of the participants changed status at least once over the follow-up period. Women are one third less likely to transition from recovery to using; the predictors of transitioning to different statuses vary by gender. The implications of gender as a moderator of the recovery process are discussed.