Background: Distress is defined as an unpleasant emotional experience that may interfere with the ability to cope with cancer or its treatment. Distress screening is recommended during transitions including survivorship. We describe distress in cancer survivors before and after participation in a multidisciplinary survivorship clinic. Methods: All patients participating in the Yale Adult Survivorship Clinic were asked to complete the National Comprehensive Cancer Network Distress Thermometer (DT) immediately before and after a visit. Survivors ranked distress from 0 (none) to 10 (extreme) and indicated associated problems from a 39-item list. A score ≥ 4 was considered clinically significant. Survivors were seen by an MD/APRN, social worker, registered dietitian and physical therapist. Survivors received individual counseling on topics including survivorship care, diet and exercise, and coping. All were offered a follow-up visit approximately 8 weeks later. Distress screening was repeated at the follow-up visit. Distress scores before and after each visit were compared using paired t-tests. Results: 377 survivors completed DTs before and after a survivorship clinic visit in 18 months. Survivors were mostly female (91%), white (77.2%), with a history of breast cancer (73%). The mean distress score prior to the initial visit was 4.82 (+/-2.82), and 2.45 (+/-2.15) after the visit (mean change -2.34, +/- 2.06, p < 0.0001). The top problems identified were worry (53%), fatigue (43%), and fears (30%). 191 survivors (51%) had clinically significant distress ( ≥ 4) before the initial visit; however, only 74 (20%) reported significant distress after the visit (p < 0.001) Of survivors who returned for a follow-up visit (N = 107), avg distress score was 4.20+/-2.97 before and 1.86+/-2.01 after (mean change -2.42, +/- 2.50 p < 0.0001). At the follow-up, 49 (46%) had clinically significant distress before and 17 (16%) after (p < 0.0001). Conclusions: More than half of all survivors participating in a multidisciplinary survivorship clinic reported clinically significant distress. Distress scores were significantly lower after the visit. These results suggest participation in a survivorship clinic is an intervention for distress.