For decades, couples around the world have used Imago relationship therapy (IRT) to improve their relationships. While anecdotal success stories abound, no randomized controlled trial of IRT’s impact has been accomplished until now. The authors review the results of a randomized controlled trial of distressed, treatment-seeking couples who completed 12 sessions of IRT and the impact their involvement had on their marital satisfaction. Results showed that (a) individuals in the treatment condition experienced statistically significant increases in marital satisfaction, while couples in the control group did not; (b) levels of marital satisfaction did decrease significantly from posttreatment to follow-up but remained significantly higher than at pretreatment; (c) though statistically significant, the improvements experienced by the treatment group were not clinically significant improvements; and (d) while approximately one-third of participants achieved recovery during treatment, at the dyad level, only one couple achieved recovery. Further analysis and recommendations for future research are discussed.