The Inner City Service for Women with Complex Needs (ICSWCN) was established in 2014 in recognition of the significant need for specialist women’s services in a rapidly shifting service sector landscape. The ICSWCN is a new partnership between three longstanding specialist women’s services; B Miles Women’s Foundation (for women impacted by mental ill-health), Community Restorative Centre (for women involved with the criminal justice system) and Detour House Inc. (for women recovering from substance dependency). The establishment of this service was founded on the understanding that too often women with multiple and complex needs fall through the gaps in the service landscape, because of their complexity of need. As a consequence, this population often also end up being ‘managed’ in institutional and criminal justice system settings, rather than being supported into the community. Remarkable outcomes are possible when highly vulnerable women are given the opportunity to access specialist support.