Throughout Sub-Saharan Africa, poverty alleviation programmes have struggled to reach the ultra-poor. To address this challenge, a growing number of agencies are adopting a ‘graduation approach’ to moving out of extreme poverty into food security and sustainable livelihoods. This study examines the effects of an integrated graduation programme (combining the economic strengthening component with the child well-being sensitisation component) on the economic well-being of women and households in the Nord region of Burkina Faso. Repeated-measures data were collected at three time points from 360 female adult caregivers in a three-arm cluster-randomised controlled trial conducted among the poorest households in the region. Results of multilevel random-intercept mixed-effectsmodels suggest significant effect of the two intervention arms on increased return from market activities and greater assets owned by the women. Results also show an increase in expenditure on children, although not at the same rate as the increases in womens’ income and profits. Findings provide strong support for the expansion of the graduation approach to help the ultra-poor in different settings. Findings also point to the importance of taking into account existing social relationships within households and suggest the added value of addressing these intra-household dynamics through appropriate programme strategies.