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This study examined the feasibility, safety, and efficacy of using tai chi for treating major depressive disorder.Thirty-nine Chinese Americans with major depressive disorder were randomized into a 12-wk tai chi intervention or a waitlisted control group in a 2:1 ratio. The key outcome measurement was the 17-item Hamilton Rating Scale for Depression. Positive response was defined as a decrease of 50% or more on the 17-item Hamilton Rating Scale for Depression, and remission was defined as a score of 7 or lower on the 17-item Hamilton Rating Scale for Depression.Of the participants (n = 39), 77% were women, and mean (SD) age was 55 (10) years. There were 26 (67%) participants in the tai chi intervention group and 13 (33%) in the control group. Of the participants in the tai chi group, 73% completed the intervention; no adverse events were reported. We observed trends toward improvement in the tai chi intervention group, compared with the control group, in positive treatment-response rate (24% vs. 0%) and remission rate (19% vs. 0%), although the differences in our small sample did not reach statistical significance.A randomized controlled trial of tai chi is feasible and safe in Chinese American patients with major depressive disorder. These promising pilot study results inform the design of a more definitive trial.