There is increased consensus on the role of adolescent girls in reaching development goals but few programs for girls have been rigorously evaluated. In Ethiopia, Biruh Tesfa (Bright Future, in Amharic) mobilizes out-of-school girls into safe space groups led by mentors. Girls receive training in literacy and life skills, and they are given vouchers for medical services. A longitudinal study was conducted to measure changes in girls’ learning outcomes and their use of health services. After adjusting for background factors, we found that girls who had never attended school in the project site had significantly higher literacy scores than did control girls. At endline, girls in the project site were 1.6 times more likely to have used a health service in the past six months than those in the control site. Girls-only safe spaces programs can be effective at improving literacy and health-seeking behavior among the most marginalized girls who otherwise lack educational opportunities and access to services.