Although outcomes monitoring and the collection of other performance data holds benefits for service managers and policy makers, the extent to which these data are collected by South African substance abuse service providers is unknown. To describe (i) the extent to which substance abuse service providers in South Africa monitor and evaluate their programmes and (ii) the availability of structures to support monitoring and evaluation activities within these services. Cross-sectional surveys of substance abuse treatment services were conducted in Gauteng and KwaZulu-Natal provinces (2006-2007) and the Central and Northern region of the country (2007-2008). A survey of prevention services was conducted in the Cape Town metropole (2008). Across all sites approximately half of the services reported never having evaluated their programmes. In addition, less than two thirds of treatment facilities routinely monitor client outcomes. Even where monitoring and evaluation did occur, less than a third of facilities used standardised questionnaires and less than two-thirds used urinalyses to collect outcomes data. Based on the above findings, a number of recommendations are made to expand monitoring and evaluation within South African substance abuse services.