Objective: To compare the effectiveness of Internet cognitive behaviour therapy (CBT) with face-to-face CBT in social phobia. Methods: Randomized controlled trial of 75 patients with social phobia referred to an anxiety disorders clinic. A total of 37 patients participated, and post-treatment data was obtained from 25 Subjects (Ss). An intention to treat analysis was used. The same therapist (M.D.) treated both groups. Results: Both groups made significant progress on symptoms and disability measures. There were no significant differences in outcome between the Internet and face-to-face groups. The total amount of therapist time required was 18 min per patient for the Internet group and 240 min per patient for the face-to-face group. Conclusions: Both forms of treatment were equally effective and this is consistent with previous findings in depression and panic disorder. The difference in clinician time required was substantial. If Internet CBT was offered as ‘standard of care’ the staff time saved would permit a stepped care model in which in-depth therapy for the difficult to recover patients could be provided without an increase in staff.