Objectives: In 2003, the Massachusetts Statewide Head Injury Program (SHIP) initiated an intensive shelter outreach program, in an effort to identify homeless persons with a history of traumatic and other acquired brain injuries. Secondary objectives included the assessment of service needs, referral to publicly funded and other community-based programs, and the provision of specialized case management. Design: Sampling. Setting: Homeless shelters in Massachusetts. Participants: With the assistance of SHIP-qualified community-based provider organizations, homeless individuals in selected shelters were screened for a history of ABI and referred to SHIP for eligibility determination. Interventions: For homeless persons with a reported ABI, medical and other clinical records were obtained, and current functional status was reviewed. On the basis of this process, eligibility for publicly funded programs was completed and recommendations were generated, with respect to needed assessments, treatment, and other services, including an innovative 13-bed transitional living program developed by SHIP for homeless persons with ABI. Results: Since 1985, when SHIP was established, only 2.8% of all SHIP referrals were documented to be homeless. However, during the first 24 months of this project, the number of homeless persons referred to SHIP increased to 19%. Among those with a documented ABI, the leading cause was trauma. The majority of applicants were male (84%), Caucasian (61%), and between the ages of 41-60 years (65%). Conclusions: The findings of this project support the hypothesis that there is, among homeless persons, a subset of individuals with a history of ABI. In addition, comprehensive review of individual cases substantiates the need for transitional programs/services that address active substance abuse, and the medical, neurocognitive, neurobehavioral, and psychosocial sequelae of ABI. Key words:acquired brain injury,homelessness,sample survey