This study examined the relationship between verbal reports of craving and actual cocaine use across different treatment phases using a longitudinal design. Participants (n = 32) were cocaine-dependent patients who completed an inpatient chemical dependency program and then participated in an 8-week outpatient relapse prevention program. Craving ratings and urine samples were collected during hospitalization, at 12 weekly outpatient treatment sessions, and at 1, 2, 4, 8, 12, and 24-week follow-up. Craving increased significantly from inpatient to outpatient treatment. Cocaine-abstinent participants reported lower craving across outpatient treatment and follow-lip compared to moderate and heavy cocaine users. The overall relationship between craving and total proportion of cocaine positive urines was highly significant. Implications of these findings for advancing our theoretical and practical knowledge about craving and cocaine use, are explored.