Multisystemic Therapy (MST) is an evidence-based treatment for high-risk youth and their families shown to reduce subsequent delinquent activity. This study investigated (a) rearrest rates of a statewide MST dissemination and (b) the relation of child, family, and case characteristics to rearrest rates following receipt of MST. Analyses examined outcomes for 633 youth following referral to MST. Separate models examined predictors of general rearrest of any type and of more serious misdemeanor or felony arrests. Sixty-five percent of youth experienced a new arrest of any type within 12 months of MST initiation; fewer (53%) experienced a misdemeanor or felony charge in that time frame. Recipients who were younger, had an externalizing behavior disorder, and had a greater number and severity of pre-MST charges were more likely to recidivate. Findings highlight potential child and case factors that may account for variability in treatment effects when MST is implemented broadly within a system.