Background: Metacognitive therapy (MCT) is an innovative treatment model addressing patterns of negative thinking seen in emotional disorders. Unlike cognitive behaviour therapy (CBT), MCT has strategies targeting dysfunctional cognitive and metacognitive processes underlying perseverative thinking patterns and attentional biases. The aim of this pilot study was to compare changes in neuropsychological functioning related to executive function and attention in outpatients with depression following treatment with MCT or CBT. Methods: 48 participants referred for outpatient treatment of depression were randomised to 12 weeks of MCT (n=23) or CBT (n=25). Mood severity and neuropsychological functioning were assessed at pre-treatment, 4 weeks and at end treatment (12 weeks). Results: There were no significant group differences at pre-treatment or 4 weeks on any neuropsychological test, although overall both groups showed a small improvement by 4 weeks. At end treatment, the MCT group demonstrated significantly greater improvement in performance on a task requiring spatial working memory and attention than the CBT group. Changes in executive functioning and attention were independent of change in mood symptoms. Conclusions: MCT may have an advantage over CBT in improving aspects of executive function, including attention. MCT’s emphasis on attentional training and flexible control of thinking may have a beneficial effect on neuropsychological functioning, consistent with the purported mechanism of action.