OBJECTIVE: The aim of this study was to compare the outcomes following an eight-session, small group, therapist-led, intervention for body dissatisfaction, and disordered eating in adult women, delivered either in face-to-face or synchronous, internet mode. METHOD: Community women with high body dissatisfaction and internet access were randomly assigned to either face-to-face delivery (N = 42), internet delivery (N = 37), or delayed treatment control (N = 37). All groups were assessed at baseline and 8-9 weeks later. The intervention groups were reassessed at 6-months follow-up. RESULTS: Both intervention groups showed large improvements in body dissatisfaction compared with the delayed treatment control and these improvements were maintained at follow-up. However, posttreatment improvements were greater in the face-to-face than internet intervention. CONCLUSION: In adult women, it is desirable to deliver the body image intervention in a face-to-face mode, but the internet mode is effective and has the potential to increase access to therapy.