The objectives of this prospective follow-up study were to identify factors that promote or impede the early recovery process and to examine whether drinking status at 4 weeks predicts later abstinence. Patients with alcohol use disorders were assessed by clinical and semistructured interviews upon entering addiction treatment (N = 175) and were followed up biweekly to monitor their alcohol use. During the first 4 weeks of treatment, 57% (n = 100) of patients slipped or relapsed on alcohol, whereas 43% (n = 75) were fully abstinent. Patients who slipped or relapsed were more likely to report nondependent use of a secondary substance, meet criteria for a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis II Cluster B personality disorder, have a higher level of impulsivity, and have more severe social problems at intake. The final logistic regression model accounted for 37% of the variance in drinking status. Patients who slipped or relapsed early in treatment were likely to continue to struggle to maintain abstinence at 12 weeks.