The aim of this study was to explore the reasons why vulnerable women refuse to take part in early interventions. In-depth interviews were conducted with 19 women who refused to take part in an evaluation of an intensive home visiting programme. A number of themes were identified including perceptions about vulnerability, misperceptions about the service, misgivings about the service, and lack of trust. It is concluded that women who refuse to take part in early interventions are a diverse group, and that service providers need to take this diversity into account, if they are to improve uptake of services by vulnerable women. Service providers may also need to consider new ways of providing services.