This report focuses on the introduction of harm reduction programs in Moldovan prisons and describes successes achieved as well as remaining challenges. Research was conducted in Moldova in August 2007 and October 2008, with seven site visits to prisons and one site visit to a pretrial detention facility, as well as visits to the headquarters of the penitentiary system and Innovative Projects in Prisons—a nongovernmental organization (NGO) that provides harm reduction services in prisons. The authors interviewed prisoners and pretrial detainees, NGO staff, and penitentiary system officials and employees at both the national and local levels.