Purpose of Review: In this article, we describe the goals of transference-focused psychotherapy (TFP), its indications, underlying theory, and its broad structure and techniques. We summarize the current empirical support for TFP in regard to symptom and personality change. Lastly, we discuss recent developments and applications in TFP. Recent Findings: TFP is a theory-based, manualized, empirically supported, outpatient psychotherapy designed specifically to treat patients with severe personality disorders, such as borderline and narcissistic personality disorders. Overall TFP focuses on consolidating identity, increasing emotion regulation, and improving relationships. In TFP, these improvements are accomplished by exploring and working through the patient’s fragmented and disparate experiences of the self and others, particularly through the relationship with the therapist. Compared with other empirically supported treatments for personality disorders, TFP has shown an equal improvement in depression, anxiety, functioning, and adjustment, and has led to a more consistent change in anger and aggression. Moreover, in three studies, TFP uniquely and consistently led to changes in attachment security and mentalizing capacity. Summary: Although TFP manuals were first developed specifically for treating borderline personality disorder, recent research suggests that TFP has broader relevance for personality pathology more generally. Furthermore, future research is needed to explicate how TFP can be integrated with other treatments.