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Youth with complex trauma comprise one of the most distressed and difficult-to-treat populations for clinicians (Complex Trauma Task Force, 2003; Luxenberg et al., 2001a). Wilderness therapy is a growing area of interest for the treatment of at-risk youth (Bowen et al., 2016; Russell, 2001). Nevertheless, the effectiveness of wilderness therapy for youth with complex trauma has yet to be evaluated empirically. This manuscript presents an evaluation of a trauma-informed wilderness therapy program, New Vision Wilderness Therapy (NVWT). Between 2009 and 2019, 816 adolescents (ages 13–17, Mage = 15.36, SD = 1.25; 41.1% female) completed the Youth-Outcome Questionnaire–SR 2.0 at intake and discharge (M = 75.02 days, SD = 28.77). Additionally, 253 adolescents completed two 2.5-minute segments of heart-rate-variability biofeedback (one while resting and one while engaging in a coping skill). Between 25 and 99 adolescents and caregivers also completed psychological and family measures at 6-months and 1-year postdischarge. Adolescents reported experiencing improvements in psychological functioning. They also exhibited improvement in psychophysiological functioning (heart-rhythm coherence). Caregivers reported improvements in their child’s psychological functioning. Caregivers also observed more persisting benefits in their child’s psychological functioning when compared to adolescent self-report. There were very few differential effects on the basis of demographic factors, trauma exposure, or past and current treatment factors. Results of this pilot study suggest NVWT is a promising intervention for improving the psychological and psychophysiological functioning of complexly traumatized adolescents.