Case management has been increasingly promoted as a strategy to prevent the initial experience of homelessness and its reoccurrence. The literature, although substantial for case management description and outcomes for individuals with mental illness, is sparse with details on how case management is implemented for families, let alone its effectiveness. The Homeless Families Program (HFP), coupling case management with Section 8 Housing have researched effectiveness in the following cities: Atlanta, Georgia; Baltimore, Maryland; Denver, Colorado; Houston, Texas; Nashville, Tennessee; Oakland, California; Portland, Oregon; San Francisco, California; and Seattle, Washington. This article presents a description of case management used in the HFP and discusses the lessons learned from studying its implementation that have application for other settings. The authors suggest that consideration needs to be given to system and agency demands on case managers, as well as the variety of competing demands inherent in providing in-home, long-term support to formerly homeless families.