Body dysmorphic disorder (BDD) is a chronic and disabling psychiatric disorder unlikely to remit without treat- ment. A systematic review and meta-analysis of randomized controlled trials (RCTs) of cognitive-behavioral therapy (CBT) for BDD was conducted, including published and unpublished trials to 26th November 2015. Primary outcomes were validated BDD measures; secondary outcomes included depression and insight. Meta- regressions were conducted to examine potential effects of variables on the primary outcome, including socio- demographic variables, comorbidity, symptom severity/duration, concomitant medication, treatment duration, andmethodologicalqualityoftheRCTs.SevenRCTs(N=299)metinclusioncriteria.CBTwassuperiortowaitlist or credible psychological placebo in reducing BDD (7 studies; delta = −1.22, 95% CI = −1.66 to −0.79) and depression symptoms (5 studies; delta = −0.49, 95% CI = −0.76 to −0.22). CBT was associated with improve- ments in insight/delusionality (4 studies; delta = −0.56, 95% CI = −0.93 to −0.19). Improvement in BDD was maintained after 2–4 months follow-up (3 studies; delta = −0.89, 95% CI = −1.24 to −0.54). Meta-regression analysesdid not reveal any significant predictors of outcome. CBTisanefficacious treatment for BDDbut there is substantial room for improvement. The specificity and long-term effects of CBT for BDD require further evalua- tion using credible control conditions. Additional trials comparing CBT with pharmacological therapies, as well astheircombination,arewarranted.Tele-careoptions,suchasInternet-basedCBT,holdgreatpromisetoincrease access to evidence-based treatment for a majority of patients who need it and should be evaluated further.