The Native American sweat lodge ceremony or sweat therapy is being used increasingly in various medical, mental health, correctional, and substance abuse treatment centers serving both Native and non-Native clients. This article explores the sweat lodge ceremony's background, elements of Native American spirituality, origin story, cultural symbolism, prayer, and contemporary use. Current evidence of effectiveness and therapeutic benefits is presented, then implications for integrating the sweat lodge ceremony as a complementary counseling approach are discussed.