Key PointsQuestionIs the Domestic Violence Housing First (DVHF) model associated with safety, housing stability, and reduced mental health symptoms over 24 months?FindingsIn this comparative effectiveness study of 344 survivors of intimate partner violence, receiving the DVHF model was associated with greater safety and housing stability and with reduced mental health symptoms over 24 months compared with receiving services as usual.MeaningThis study provides evidence of the effectiveness of DVHF in promoting the safety and well-being of survivors over time, highlighting the importance of investing in domestic violence agencies’ use of survivor-driven housing advocacy and flexible funding.