The health needs of pregnant opioid dependent women are increasingly being recognized by health care professionals. These women generally receive limited antenatal care. Maternal and neonatal outcomes are also poorer compared to non-drug using women. The number of pregnant opioid dependent women accessing drug treatment services in the Irish Republic has increased. A specialist Drug Liaison Midwife service was created in March 1999 to liase between the three Dublin Maternity hospitals and the Drug Treatment Services. This paper surveys the first year of operation of one of these posts. It documents socio-demographic background, substance use, and medical histories of these women in addition to maternal and neonatal outcomes. Higher maternal methadone dose was associated with an increased risk of neonatal withdrawals among these women. The experience of this specialist liaison service indicates that it is possible to build effective working relationships between opioid dependent pregnant women and the Obstetric and Drug services involved in their care.