The therapeutic alliance has been established as a consistent predictor of outcome in individual therapy with adults. In family therapy, research on the alliance is a relatively new field. The purpose of this literature review was to examine the association between the therapeutic alliance and outcome in family therapy. The study examines both the alliance between children/adolescents and therapist and the alliance between parents and therapist, and these alliances’ relations with outcome. 26 articles were included, and a large number of these have found associations between both types of alliances and outcomes. There is a tendency for the alliance between parent and therapist to be more related with drop-out or retention than the alliance between youth and therapist. There is also a tendency for the alliance between youth and therapist to be more related with youths’ psychological improvement. Split alliances seem to be related with drop-out. The studies are varied, and they have some methodological limitations. For these reasons, more studies on the associations between the alliance and outcome in family therapy are needed.