The current study aimed to provide a preliminary evaluation of the differential efficacy of a cognitive-behavioural treatment program for female pathological gamblers delivered with the goals of abstinence or controlled gambling. The findings were based on the comparison of pathological gamblers selecting abstinence and pathological gamblers selecting controlled gambling on measures of gambling behaviour and psychological functioning. The findings revealed that pathological gamblers selecting controlled gambling displayed comparable levels of improvement to those displayed by gamblers selecting abstinence. Using a treatment completer approach, 89% of the gamblers selecting abstinence compared with 82% selecting controlled gambling no longer satisfied the diagnostic criteria for pathological gambling by the completion of the 6-month follow-up period. Although further scientific demonstration is required, the findings of this study provide preliminary support for the practice of offering controlled gambling as an alternative goal in the treatment of pathological gambling.