our objective was to compare the effects of Virtual reality exposure therapy (VrEt), cognitive behavior therapy (cBt), and a waitlist control condition in patients with panic disorder with agoraphobia (PdA). ninety two out-patients were ini-tially randomized in three arms, 29 treated with VrEt, 31 with cBt, and 32 assigned to the waitlist. At the end of a 12-week period, the patients assigned to the waitlist were re-randomized in VrEt or cBt groups. no between-group significant differences appeared at the end of the first phase, however a lower responder rate was observed in the waitlist group. After the second randomization, response rates were not different in the VrEt and cBt groups (respectively 38.7% and 48.5%; p=0.46). during the 9-month follow-up period, the response rates remained stable without differences between groups. thus, VrEt seems to be an effective treatment for PdA with short-term and long-term therapeutic results equiv-alent to those obtained with cBt.