BackgroundSubstance dependency is a global problem and significantly affects the geriatric population in the United States. This study aims to determine how self-help group (SHG) attendance affects substance use treatment outcomes among older adults in the US. MethodsThis cross-sectional study used the 2020 discharge treatment episodes data set (TEDS-D)fromthe Substance Abuse and Mental Health Services Administration (SAMHSA). Multivariable logistic regression was used to evaluate the relationship between self-help group attendance and treatment outcomes among older adults. ResultsWe included 3,424 older adults (19.2% female). The primary substance use was alcohol in more than two-thirds of the participants (67.9%), while heroin (17.1%), cocaine (5.8%), and other opiates/synthetics (3.3%) were the other common primary substance of abuse among other participants. In the multivariate logistic regression analysis, SHG attendance at discharge from treatment facility was significantly associated with reduced frequency of use of primary substance -FUPS (p-value = 0.013) and increased odds of treatment completion (p-value <0.001) but no significant association with arrests at discharge from treatment facility (p-value = 0.101). SHG attendance on admission into treatment facility was associated with reduced odds of treatment completion (p-value <0.001). Having a living arrangement at discharge was found to be associated with reduced FUPS (p-value <0.001) but with lower odds of treatment completion (p-value <0.001). ConclusionAssociation of SHG attendance with positive treatment outcomes indicates the need to enhance access to this service in the geriatric population.