Problem-solving criminal justice is the court-based approach developed in efforts to tackle social, health and lifestyle problems linked to repeat patterns of criminal offending. Typically, these cover drug and alcohol dependence issues, mental disorder and youth and early independence vulnerabilities. This paper presents a critical analysis of three specific forms of problem-solving practiced in the English and Welsh court system – youth sentence review panels, the Family Drug and Alcohol courts and adult drugs courts. Empirical research is used to discuss the effectiveness and outcomes of these court approaches and argues realistic expectations in terms of what is considered ‘success’ for those attempting to become drug free, or establish conventional pathways and desist from crime, is essential. The barriers and obstacles preventing a more extensive application of problem-solving criminal justice is also discussed, drawing on points connected to sentencing parameters, ‘political will’ and legal cultural impediments. It is suggested if problem-solving justice is to become more widely established in local and geographical areas of need, alterations are needed to the way court innovation is enabled. Specifically, closer working relations between the professional judiciary and the large body of volunteer ‘lay’ magistrates who preside over much lower criminal court judging in England and Wales is necessary.