Traditional courts often have a primary focus on punishment and containment rather than rehabilitation, which arguably neglects to address the underlying mechanisms contributing offending behaviour. Therapeutic courts, on the other hand, endeavour to reduce recidivism by addressing specific criminogenic needs and tailoring treatment plans to meet the unique needs of offenders through the court process. These treatment plans can encompass access to additional support services and therapy and occur alongside judicial monitoring to ensure community safety is upheld whilst focusing on reducing recidivism. In the present study we conducted a comprehensive meta-analysis to examine the efficacy of therapeutic courts in reducing recidivism. Forty-two empirical studies were included in the meta-analysis, which found significant, small to moderate reductions in recidivism for therapeutic court participants across both mental health and drug courts. Highlighting the importance of rigorous control group selection, a larger reduction in reoffending was found when therapeutic court non-completers were used for the control group, compared with matched control groups who went through traditional court processes. There were several methodological factors of the original studies that may limit the generalisability of conclusions drawn from the current meta-analysis, including short follow up periods, especially among the mental health court data, and a large degree of heterogeneity identified across studies, both in terms of how the therapeutic courts ran, and in the measured effect itself. This highlights the heterogeneity in how therapeutic courts are being implemented, and the need for additional research on the court factors that are most and least useful in addressing recidivism. Despite these limitations, the current paper provides promising evidence for the efficacy of therapeutic courts, providing support for the ongoing implementation of this alternative courts system.