Virtual reality exposure has recently emerged as an important tool for exposure therapy in the treatment of fear of flying. There have been numerous empirical studies that have evaluated the effectiveness of virtual reality exposure as compared to other treatments including in vivo exposure, progressive muscle relaxation, cognitive therapy, bibliotherapy, and supportive group therapy. The results of two case studies and eight outcome trials have indicated that virtual reality exposure is comparable or superior to these treatments. However, the best results, as indicated by a reduction in self reported anxiety and fear experienced during an actual flight, were obtained when virtual reality exposure is combined with cognitive interventions. (Contains 1 table.)