Peer support groups are and have historically been a significant component of recovery from alcohol and substance use disorders. Perhaps the most well-known peer support group, Alcoholics Anonymous or “AA,” was formed out of the progression of predecessor groups. Bill Wilson, one of AA’s cofounders, was directly influenced by a member of the Oxford Group—a Christian fellowship from which AA borrowed many of its principles. Since its inception, AA has spread globally and has widely popularized the 12-step method to recovery. Many new groups have formed by directly adopting the AA model but gearing their fellowship toward individuals with specific addictions other than alcohol. Here, we review the history of the 12-step recovery model, the nature of the steps themselves, the fellowship and meeting structure of AA and its offshoots, and other useful details regarding the nature of 12-step recovery programs. We review the current literature and data regarding the successes and shortcomings of the 12-step model as well as the shortcomings of the data itself.