Drug consumption rooms (DCRs) have operated in Europe for more than 20 years. At the time of this study three Australian jurisdictions were considering trials of DCRs and little information about these services was available in the English literature. We surveyed 39 DCRs in the Netherlands, Germany, Switzerland and Spain in 1999-2000 regarding service delivery and perceived public health and amenity impact and 15 (40%) responded. The DCRs surveyed were professionally staffed, low threshold services which provided a range of health, psych-social, drug treatment and welfare services and referrals. No overdose deaths were reported and the estimated rate of non-fatal overdose ranged from 1 to 36 per 10,000 visits. These DCRs appeared to be achieving their service delivery objectives with few negative consequences.