Objective To describe the implementation of early intervention for psychosis in 3 French-speaking countries, the challenges encountered and potential facilitators for successful implementation. Methods Narrative synthesis of the scientific and grey literature on early intervention for psychosis programs implementation in the French-speaking world. Results Compared to other countries (Australia, United Kingdom, etc.), early intervention program implementation in the French-speaking world has been delayed and faces various challenges, making its widespread implementation still very heterogeneous. Although a large proportion of the population has access to early intervention services (EIS) in Quebec (Canada), adherence with certain essential components of the model still poses challenges. However, various facilitators, including government involvement through the publication of a provincial framework standardizing practices, dedicated funding, and clinical support for program implementation and continuous improvement through the National Centre of Excellence in Mental Health (a provincial organization) and a provincial community of practice, the Association québécoise des programmes pour premiers épisodes psychotiques (AQPPEP), which offers mentoring and continuing education, have been identified. In France, although the implementation has been more heterogenous, several centers already offer EIS, and there is growing interest in this model, as expressed by several teams, giving hope for the implementation of a network of EIS throughout the country. Since 2007, the "Réseau transition" has been organizing scientific meetings, specialized training, validation of tools and is working on publishing a reference tool adapted to the French system to standardize EIS. In French-speaking Switzerland, although programs were implemented relatively early (in 2000 in Geneva, and in 2004 in Lausanne), they remained associated to individual initiatives and local choices. This is largely due to the complete autonomy of each of the 26 cantons in the organization of the healthcare system and the absence of a national mental health policy. However, a French-speaking Swiss group has been set up in 2020, to support the implementation of 5 programs in 5 cantons. Several specificities of the organization of mental health care in each country may have an impact on implementation. These include the relative autonomy of different catchment areas, and the separation of child and adolescent psychiatry from adult services. Furthermore, it seems that poor involvement in quality assurance activities and the lack of monitoring of adherence to expert recommendations on essential components of the EIS model may impact program implementation. Conclusion In addition to continuing national efforts, a francophone branch of the International Early Psychosis Association (IEPA) founded by Swiss, French and Quebec leaders to join forces on a larger scale seeks to promote networking as well as tool and expertise sharing through an annual international francophone conference focused on early intervention in first-episode psychosis.