In this article we report research findings from a qualitative study of social support for immigrants and refugees in Canada. We focus on challenges from the perspectives of 137 service providers and policymakers in health and immigrant settlement who participated in in-depth interviews and focus groups in three Canadian cities. Results show that social support is perceived to play an important role in immigrant settlement and to have a positive impact on immigrant health, although immigrants face many systemic challenges. Systemic issues--limited resources, lack of integration of policies and programs and narrow service mandates--also limit service providers' abilities to meet newcomer's needs. This research suggests that changes in public discourse about immigrants' contributions, improved governance and service coordination, and a holistic, long-term perspective are important to more effectively support immigrant settlement and to promote immigrant health and well being.