Emotionally Focused Couple Therapy (EFT), as developed by Greenberg and Johnson (1988) and Johnson (1996Johnson ( , 2004Johnson ( , 2020, is an evidence-based treatment that works with a variety of presenting concerns (e.g., depression, posttraumatic stress disorder, sexual dissatisfaction) and treatment characteristics, with good maintenance of treatment gains up to 2 years following treatment. In this first comprehensive meta-analysis of EFT, we evaluated the entirety of efficacy outcome research including randomized controlled trial (RCT), quasi-experimental, and dissertation studies. Previous meta-analyses of EFT analyzed solely RCTs (Beasley & Ager, 2019), Johnson's model of EFT combined with Greenberg and Goldman's (2008) conceptually different model (Rathgeber et al., 2018), or EFT embedded and not disentangled from other models of couple therapy (Roddy et al., 2020). Across 20 studies and 332 couples, we found medium to large random effects weighted ds for (a) pretest-posttest, d = .93, 95% CI [.75, 1.12], (b) EFT versus viable alternative couple interventions, d = .44, 95% CI [.03, .85], and (c) pretest to follow-up, d = .86, 95% CI [.56, 1.15]. Comprehensive sensitivity and moderator analyses were conducted. This meta-analysis provides support for EFT as an evidencebased couple therapy approach, where 70% of couples will be symptom free at the end of treatment and greater therapist fidelity to the model is associated with stronger couple gains. Limitations and implications are discussed in relation to research, training, and practice of EFT.This document is copyrighted by the American Psychological Association or one of its allied publishers.This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.