Therapist empathy has long been recognized as an important therapeutic factor across different psychotherapies. However, despite its widely accepted clinical importance, empathy is conceptually complex, and its relation to other psychotherapy constructs and to therapy outcomes remains empirically unclear. The current study examined the association between empathy and the therapeutic alliance, as well as their respective and potentially interactive associations with treatment outcome. Using confirmatory factor analysis, structural equation modeling, and path analysis, these relations were examined in the context of cognitive-behavioral therapy (CBT) for generalized anxiety disorder (GAD), a condition for which little research exists on treatment process and relationship variables. Although not all path analyses could be interpreted because of the relatively small sample size (N = 69), the results indicated, as predicted, a distinction between therapist empathy and the global therapeutic alliance, as well as therapist empathy and the alliance components (viz., bond, tasks, and goals). Empathy and the therapeutic alliance differentially predicted outcome as measured by global anxiety symptomatology level. In addition, a model where early empathy’s relationship to outcome was mediated by the middle alliance was a significant improvement over a model without the mediation.