Emotionally focused therapy (EFT) for couples is an empirically supported treatment for relationship distress (Johnson and Greenberg Journal of Consulting and Clinical Psychology 1985a;53:175–184; Johnson, The practice of emotionally focused marital therapy: Creating connection. New York: Brunner-Routledge, 2004). Despite strong evidence of a link between experiences of childhood abuse and problems in intimate relationships during adulthood (Paradis and Boucher, Journal of Aggression, Maltreatment & Trauma 2010;19:138–158; Walker et al., Journal of Family Violence 2009;24:397–406), there have not yet been any controlled trials of the efficacy of EFT for adult survivors of childhood abuse. In light of evidence of the effectiveness of individual EFT in the treatment of the sequelae of complex trauma (Paivio and Pascual-Leone, Emotion-focused therapy for complex trauma: An integrative approach. Washington, DC: American Psychological Association, 2010), we conducted the first randomized controlled trial of EFT for couples in which the female partner had a history of intrafamilial childhood abuse. Our primary hypothesis was that couples treated with EFT would experience a significant reduction in relationship distress. To test this hypothesis, 24 couples in Toronto, Ontario, Canada (mean relationship length = 14 years), were randomly assigned to either a treatment group (24 sessions of EFT) or a control group (waiting list). Analyses of covariance with treatment condition as the fixed factor and baseline scores on the Dyadic Adjustment Scale (Spanier, Journal of Marriage and the Family 1976;38:15–28) as the covariate yielded a statistically significant effect of treatment group on relationship distress. Hierarchical regression analyses unveiled the particular circumstances under which EFT appeared to be effective. These results attest to the effectiveness of EFT for relational distress in trauma survivors and are discussed in light of the relevant clinical literature.