Objectives: This article presents a systematic evaluation of the effectiveness of interventions aimed at reducing distress in adult victims of rape and sexual violence. Method: Studies were eligible for the review if the assignment of study participants to experimental or control groups was by random allocation or parallel cohort design. Results: Six studies including 405 participants met eligibility criteria. Meta-analyses revealed that specific cognitive and behavioral interventions (cognitive-processing therapy, prolonged exposure therapy, and eye movement desensitization reprocessing) had a statistically significant effect on posttraumatic stress disorder and depression symptoms in comparison to the control groups. Other outcomes that had demonstrated improvement included anxiety, guilt, and dissociation. Conclusion: Many studies assessing the effectiveness of interventions for decreasing trauma symptoms combine victims of sexual violence in adulthood with other trauma-based samples despite the profound differences in these experiences. This review again points to the need for increased research that focuses specifically on the effectiveness of treatment models for adult victims of sexual violence. (Contains 6 figures.)