Exposure therapy, despite its demonstrated efficacy for chronic PTSD, remains underutilized across clinical settings. One suggested cause is that traumatized clients may not prefer exposure treatment. This paper reviews the current literature on factors associated with treatment preference for exposure therapy. Contrary to expectations, exposure-based therapy is not only perceived as a viable therapy but is well regarded among current therapy choices by potential clients. In particular, we highlight the central role of client beliefs about the need to talk about problems, the efficacy of treatment, and perceived need for help as crucial factors potentially impacting preference for exposure therapy. Importantly, fear of exposure treatment does not appear to play a significant role. To increase utilization, clinicians should provide clients information to address factors believed to increase preference for effective treatment.