This study examines 24-months post-baseline outcomes for thirty-five Swedish antisocial youths who received either treatment in multidimensional treatment foster care (MTFC) or treatment as usual (TAU). MTFC is a community-based treatment programme that has been successful in treating chronic juvenile offenders in the USA. This study is the first randomized control study outside the USA. The youth treated in the MTFC programme consistently showed some statistically significant positive treatment effects compared to the youth exposed to TAU. The results suggest that MTFC might be an effective method in treating youth with severe behaviour problems in a Swedish context. The authors conclude that the programme ought to be of great interest for Swedish social services as an alternative to traditional care.