This is the main report presenting findings of the study, Assessment of American Indian, Alaska Native, and Native Hawaiian Housing Needs, conducted for the U.S. Department of Housing and Urban Development (HUD). This report focuses on circumstances, needs and policy in and around American Indian and Alaska Native (AIAN) tribal areas. It is the first such report since implementation of the Native American Housing Assistance and Self-Determination Act (NAHASDA), which gives the tribes primary responsibility for the use of federal and other assistance in addressing housing needs. This report analyzes census data and presents the results from a major in-person survey of households in tribal areas, a survey of tribal housing program administrators, and site visits to tribal areas. It also presents policy and program reviews related to NAHASDA based on interviews, document reviews, and analysis of HUD management data. Additional final reports of this study address mortgage lending on tribal lands, housing needs of American Indians and Alaska Natives in urban areas, and housing needs of Native Hawaiians.