Telepsychotherapy is a cutting-edge intervention that shows great promise in the mental health care field. However, the possibility of developing a high-quality therapeutic alliance is often doubted when psychotherapy is provided remotely. This study assesses the development of a therapeutic alliance in individuals with posttraumatic stress disorder who were treated either by videoconference therapy or a face-to-face therapy. Forty-six participants with PTSD received cognitive behavioral therapy, 17 of them by videoconference and 29 in person. A variety of questionnaires evaluating the quality of the therapeutic relationship were administered at five different times during treatment. Each session was also assessed by the therapist and the participant immediately afterwards. The results indicate that a therapeutic alliance can develop very well in both treatment conditions and that there is no significant difference between the two. Certain clinical and practical implications are discussed.