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This study reports the treatment utilization of 77 women with post‐traumatic stress disorder (PTSD) and substance dependence in three areas: lifetime utilization, past thirty days utilization, and perceived helpfulness/harmfulness of current treatments. Results indicated high lifetime treatment utilization overall, yet, for one subgroup, no treatment exposure at all. Most current treatments were focused on SA, in striking contrast to participants' preference: over 80% would choose either combined SA/PTSD treatment or PTSD‐alone treatment. The most common treatments were individual therapy, medication, and hospitalization. Some treatments were perceived as harmful by some participants. The discussion addresses how to help patients obtain needed treatments.