The Neighborhood Union provided a variety of services for communities in Atlanta, including health initiatives, art and recreational activities, and even led infrastructure repair efforts in dilapidated neighborhoods. After a few years of operation, the Neighborhood Union began working cooperatively with the Atlanta Anti-Tuberculosis Association, Red Cross, City Council, and other organizations. These organizations adopted the Neighborhood Union's systems of record keeping, because it proved to be effective. The Neighborhood Union conducted various surveys, including sanitary surveys. The one featured below is an example of the sanitary surveys that were conducted in various districts throughout Atlanta by Atlanta University Center students and members of the Neighborhood Union. They provided details for the living conditions of families, the size and condition of their yards, whether or not they had toilets and sinks, where the garbage and ashes were kept and disposed of, and other details. This information helped the Neighborhood Union get a sense of the needs in a particular area and where sanitary improvements needed to be made.
The Neighborhood Union offered other services including free medical clinics at a neighborhood house in Summerhill in the early 1900s. It was one of several clinics set up throughout the neighborhoods to serve the needs of the Black Atlanta community. Doctors, dentists, and nurses would often volunteer their time to see patients and to treat ailments, such as tuberculosis along with the Anti-Tuberculosis Association, as well as offerclasses in nursing, hygiene, prenatal care, and infant care.
Beyond health programs, The Neighborhood Union members also assisted in disaster relief around the South. The Neighborhood Union was called upon by Secretary of Commerce, Herbert Hoover to participate in relief efforts for the Mississippi River flood in 1927. The flood affected many states including Mississippi, Kentucky, and Tennessee. Lugenia Burns Hope received telegrams sent to her personally by Hoover asking for the Union's assistance and thanking their membership for the help they provided.
The Neighborhood Union was also involved with orphanages for Black children such as Leonard Street Orphan Home and the Carrie Steele Orphanage. The women of the Neighborhood Union concentrated their efforts on providing alternatives to young adults through education, after school programs, arts initiatives, and better health care. They continued to campaign to have essential services provided in their communities, such as recreational facilities, improved educational facilities, better sanitation, safer streets, and proper lighting. Their community-oriented approach helped to end segregation and discrimination in the city.