Individual placement and support (IPS) has not been tested experimentally among people recently housed with a scattered-site Housing First program. Ninety recently housed people were randomized to IPS or usual services. Regression models estimated via GEE were used to compare employment outcomes. Over 8 months of follow-up with good fidelity, fifteen (34 %) people in the IPS group versus nine (22 %) in the control group found competitive employment (p = 0.16). Adjusted odds of obtaining competitive employment were greater in the IPS group (OR 2.42, 95 %CI 1.13-5.16). Other employment outcomes were not significantly different between groups. Satisfaction with services was greater in the group receiving IPS. In this study, IPS was a modestly useful adjunct to scattered-site Housing First for people with mental illness who have been homeless.