This study reports on the results of a 19-year follow-up of children born to mothers in a randomized trial of nurse home visiting and focuses on their graduation from high school, employment, sexual behavior, childbearing, substance use, and crime. Girls visited by nurses during pregnancy and infancy were less likely to have ever been arrested or convicted than were youth in the comparison group; there was no significant effect on crime in males. Females in the nurse-visited group born to high-risk (unmarried and low-income) mothers had fewer children and were less likely to have received Medicaid than high-risk females in the comparison group. There were no overall treatment effects on high school graduation, economic productivity, number of sexual partners, use of alcohol or illegal drugs, use of birth control, teen pregnancy or childbearing, or use of welfare, food stamps, or Medicaid. Given that other long-term follow-up studies of model early childhood interventions for infants and preschoolers have reported continued treatment effects with older adolescents and young adults, the impact of well designed and implemented early interventions on crime reduction is promising.