Background Studies suggest strong links between adverse childhood experiences (ACEs) and poor adult health and social outcomes. However, the use of such studies in non-US populations is relatively scarce. Methods Retrospective cross-sectional survey of 1500 residents and 67 substance users aged 18–70 years in a relatively deprived and ethnically diverse UK population. Results Increasing ACEs were strongly related to adverse behavioural, health and social outcomes. Compared with those with 0 ACEs, individuals with 4+ ACEs had adjusted odds ratios of the following: 3.96 [95% confidence interval (CI): 2.74–5.73] for smoking; 3.72 (95% CI: 2.37–5.85) for heavy drinking; 8.83 (95% CI: 4.42–17.62) for incarceration and 3.02 (95% CI: 1.38–6.62) for morbid obesity. They also had greater risk of poor educational and employment outcomes; low mental wellbeing and life satisfaction; recent violence involvement; recent inpatient hospital care and chronic health conditions. Higher ACEs were also associated with having caused/been unintentionally pregnant aged