BACKGROUND While CBT has been found to be an effective treatment for anxious older children, it has not been empirically validated in children younger than 8 years. In this study we report on an open pilot trial to establish whether a modified form of CBT can benefit young children. METHODS Participants were 37 anxious children aged 37-89 months attending a university anxiety specialty clinic. Symptom severity and functioning were assessed before and after treatment by independent evaluators. Feasibility and acceptability of the intervention were high. Parents attended part of each treatment session and were considered part of the treatment team. RESULTS Patients exhibited significant improvement from pre - to post-treatment assessments after an average of 8.3 treatment sessions, using the Strengths and Difficulties Questionnaire (SDQ) and the Global Assessment of Functioning Scale (GAF) ratings. CONCLUSIONS A modified form of CBT with active parent involvement may be a useful tool in treating anxiety disorders in preschool and early school aged children.