OBJECTIVES: To evaluate the clinical effectiveness of telepsychotherapy compared to care as usual or face-to-face psychotherapy for depressive disorder. METHODS: We searched 4 international electronic database including MEDLINE, Embase, CENTRAL, PsycINFO and 5 domestic electronic database from its inception to April 2015. Synchronous and interactive telepsychotherapy articles were included, and the study design was limited to RCT only. Two reviewers independently conducted the data extraction and quality assessment using the Cochrane Risk of Bias tool. RESULTS: A total 12 articles (10 trials) with 2,562 patients were included. From the 10 trials, 7 were comparing with care as usual, and 3 were comparing with face-to-face psychotherapy. In comparison with telepsychotherapy and care as usual, depressive symptom score was significantly lower in the telepsychotherapy (SMD -0.33, 95% CI –0.57 ~ -0.08, I=74%). Respectively, teleconferencing and web-conferencing showed significant improvements by subgroup analysis. Especially, improvement of depressive symptom was significantly higher for telepsychotherapy in studies where telepsychotherapy was performed more than twice a month (SMD -0.48, 95% CI –0.72 ~ -0.25, I=16%), and the follow up period was between 4-11 months (SMD -0.36, 95% CI –0.57 ~ -0.16, I=31%). 2 articles compared telepsychotherapy and face-to-face psychotherapy, but each study had a different target population and intervention modality. They showed controversial results in depressive symptom score (Respectively, SMD 0.39, 95% CI 0.15 ~ 0.63, SMD -0.33, 95% CI -0.68 ~ 0.01). CONCLUSIONS: Telepsychotherapy may be effective than care as usual in depressive symptom improvement in patients with depressive disorder. However most of the articles were published before 2012 as telephone, so additional studies are needed to confirm the clinical effectiveness of telepsychotherapy, especially compare with face-to-face psychotherapy.