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This is the second civil society-led monitoring report produced by Correlation – European Harm Reduction Network (C-EHRN). The purpose of this report is to enrich the information and knowledge base of harm reduction interventions in Europe from the viewpoint of civil society organisations. The Monitoring report gathers data on the experiences of harm reduction service providers and service users at ground level, building on a network of national Focal Points (FPs) in Europe. For the 2020 monitoring, C-EHRN includes 35 FPs in 34 countries. To get insight at the implementation level, and to profit from the experiences and expertise of FPs, the 2020 monitoring focuses mostly on cities rather than countries. The main areas monitored are: essential harm reduction services, overdose prevention, Hepatitis C, New drug Trends, Civil Society Involvement and COVID-19 impact on harm reduction services and people who use drugs.