Purpose: The purpose of the present meta-analysis is twofold: 1) determine the aggregated statistical effect of cognitive-behavioral couples therapy (CBCT) for relationship distress in randomized controlled trials and 2) use the findings to inform clinical social work practice and research. Methods: A systematic review was conducted using electronic databases and the reference lists of included studies. The random effects model meta-analysis used a hedges' g effect size. Results: After the removal of an outlier, a homogeneous (Q = 16.66, df = 12, p = .16, I 2 = 27.96), significant, moderate effect favoring CBCT (Hedges' g summary effect = .421, Z = 4.51, p < .0001, 95% confidence interval: 0.238 to 0.604, standard error = .093, variance = .009, k = 13) was obtained. Discussion: It is anticipated that cognitive-behavioral/evidence-based social work clinicians and researchers will use the findings to support their clinical practice and advance their clinical research, respectively.