Abstract: Few studies have examined the relationship between childhood maltreatment and substance use in later life considering household dysfunction variables especially in Eastern Mediterranean countries. The study was conducted to explore the relationship between adverse childhood experiences and substance misuse during later life in an Iranian sample. A case control study was conducted in Kerman, a city located in southern Iran in 2005. Cases were 200 men and women referred to outpatient clinics of the city seeking treatment for substance use disorder. Controls (n = 200) were selected from the general population. With emphasizing the confidentiality and obtaining oral consent the subjects were asked to fill out a questionnaire including demographic variables and 27 questions concerning all types of child abuse/neglect and household dysfunction. Using multivariate logistic regression the associations between baseline characteristics, childhood maltreatment and household dysfunction variables and substance use disorder were analyzed. The mean age of case group was 32.5±8.3 and in control group was 28±9.3 (p<0.01). Most of subjects in both groups were male. The prevalence of sexual abuse, household substance use and household criminality were higher in substance dependent patients comparing to control group. The highest odds of substance use disorder was associated with household substance abuse (OR: 2.50, 95% CI: 1.53-4.10) and sexual abuse was the only type of childhood maltreatment which showed significant association with substance use disorder in later life (OR: 1.73, 95% CI: 1.03-2.92). The related factors uncovered by the study conduct us to early interventions among dysfunctional families to decrease the maladaptive lives and stressful household environments.