AbstractObjectivesThe Centers for Disease Control and Prevention (CDC) cite access to sterile syringes as a key component of a comprehensive strategy aimed at limiting the spread of infectious disease among people who inject drugs (CDC, 2020, America’s drug overdose epidemic: Data to action). In an effort to implement best‐practice, inform stakeholders, and improve the current availability of services, a needs‐based syringe distribution model was piloted at one local syringe service program.DesignA needs‐based syringe distribution model was piloted at one syringe program location for 5 months. An analysis of pre‐ and post‐implementation program utilization data was conducted.SampleInclusion criteria included current participation in syringe service programs at the identified location. Participants from other locations were excluded.MeasurementsThe following program utilization measures were analyzed: volume of syringes distributed, new client enrollment, routine client visits, and utilization of ancillary services such as on‐site testing and naloxone distribution.ResultsEngagement increased across all four program utilization measures during the implementation of needs‐based distribution.ConclusionsImplementation of a needs‐based syringe distribution model can increase the effectiveness of syringe service programs by increasing individual syringe coverage, which reduces high‐risk injection behavior, such as syringe reuse and sharing.