This is the first study on patient evaluation of the psychosocial treatment interventions within the four Methadone Maintenance Programmes (MMP) in Sweden, i.e. Uppsala, Stockholm, Lund and Malmö. The study was performed in two phases. An inventory of psychosocial treatment elements was conducted through interviews with managements or responsible staff members. The Stockholm MMP offers many psychosocial activities and interventions within its own organisation, while the other programmes are highly dependent on co-operation with municipal social welfare services. Uppsala and Lund MMP run distance MMP-services in co-operation with local psychiatrists in other parts of the country. A questionnaire based on the inventory was completed by 190 patients, rating the importance of different elements and to what extent their respective needs had been met. In general, the psychosocial elements were regarded as important by patients in all programmes. Female patients rated daily activities and co-operation with municipal social services as more important than men did. Patients in early phases of treatment rated relapse prevention support, daily activities and involvement of relatives as more important than patients in late phases did. There were also differences between the four programmes in evaluations of how needs were met. In conclusion, psychosocial treatment elements were regarded as highly important by patients in MMP, and there is a demand for more and stronger such elements