Treatment courts are designed to provide a continuum of care intended to support participants as they experience the structure of the criminal justice system, the opportunities for change provided by treatment programs, and the support available through social services. Despite the growing use of Peer Recovery Support Specialists (PRSSs) in treatment courts, little is known about their qualifications, roles, or effectiveness. To address this knowledge gap, a national survey of adult drug treatment court coordinators was conducted to understand how these programs are using PRSSs and whether common structures of implementation are emerging.