ObjectiveThe objective was to directly compare the effects and acceptability of telephone‐based (TEL‐CBT) with face‐to‐face cognitive‐behavioral therapy (F2F‐CBT) for family caregivers of people with dementia (PwD).MethodCaregivers for whom F2F participation was possible were allocated to F2F‐CBT (n = 49). The other participants were randomized to TEL‐CBT (n = 139) or CG (n = 134). CBT consisted of 12 sessions over 6 months.ResultsTEL‐CBT yielded significantly better physical health (d = 0.27) and coping with daily hassles (d = 0.38) at posttest compared to F2F‐CBT. Therapist competence, acceptability, and outcomes at follow‐up did not differ between TEL‐CBT and F2F‐CBT.ConclusionsTEL‐CBT is a valuable alternative to F2F‐CBT for family caregivers of PwD as TEL‐CBT has the advantage of higher accessibility while it does not significantly differ from F2F‐CBT in effectiveness and caregivers' evaluation of the setting, their experience with the therapist, and their satisfaction.