Initially, the purpose of this literature review was to compare the results of the first French survey on needle exchange programs with previously published international studies. However, given the pioneering and cross-cutting nature of this study, which limits the points of comparison, we nevertheless chose to take a step further and expand our review to include all existing data on the characteristics and effectiveness of needle exchange programs (NEPs). Any comparison of this study with foreign studies on NSPs must take into account the context in which they were conducted, particularly the role of the exchange or free distribution system within the overall supply of syringes, whether a prescription is required for purchase at a pharmacy, the program’s duration at the time of the study, and whether it is official or clandestine—as is sometimes the case in the United States— how the NSPs operate, and their role within the prevention and care system for drug users.