To measure the incidence of homelessness among youths discharged from an inpatient facility as well as to identify factors that place these youths at risk for homelessness. Reports of homelessness during 5 years of follow-up interviews with 83 adolescents consecutively discharged from an inpatient facility were used in conjunction with chart reviews. One third of youths experienced at least one homeless episode after discharge. Youths who had a history of substance use, physical abuse, running away, or being in state custody were more likely to become homeless than those without such factors. Having a thought disorder, however, was inversely related to becoming homeless after hospital discharge. Youths discharged from a residential treatment facility are at high risk for becoming homeless. Interventions to prevent homelessness among adolescent inpatients should be targeted to those with a history of substance abuse, physical abuse, running away, and being in state custody.