This article provides an extensive review of Cognitive Behavioral Therapy (CBT) as a leading evidence-based treatment for Post-Traumatic Stress Disorder (PTSD), addressing foundational concepts, core therapeutic techniques, comparative approaches, challenges, future innovations, and practical clinical recommendations. It begins with an overview of PTSD diagnostic criteria and the historical development of CBT in trauma treatment, emphasizing the cognitive model that links trauma-related maladaptive beliefs and behaviors to PTSD symptoms. Early intervention and psychoeducation are highlighted as essential for fostering patient understanding and engagement, while core CBT principles such as behavioral activation, exposure therapy, and cognitive restructuring form the treatment’s backbone. Integration of exposure with cognitive techniques, alongside careful monitoring of patient progress and tolerance, is emphasized to maximize therapeutic benefits. The article reviews a robust body of clinical evidence, including randomized controlled trials and meta-analyses, confirming CBT’s effectiveness across varying PTSD severity levels and long-term outcomes. It explores adaptations of CBT for diverse populations such as children, veterans, refugees, and individuals with comorbid conditions, stressing cultural sensitivity, language accessibility, and community-based delivery models. Key challenges include high dropout rates, therapist shortages, patient resistance to exposure, and limitations in treating complex trauma, alongside ethical considerations related to trauma re-exposure and adverse symptom exacerbation. The discussion further compares CBT with other modalities like Eye Movement Desensitization and Reprocessing (EMDR), Narrative Exposure Therapy, psychodynamic, somatic, and mindfulness-based therapies, advocating for integrated, personalized treatment approaches that address patient-specific needs. Looking forward, the article highlights promising innovations such as digital CBT platforms, teletherapy, AI-assisted personalized interventions, and virtual reality exposure therapy that expand accessibility and engagement. Public health initiatives aimed at scaling CBT through task-shifting and community programs, especially in resource-limited settings, are also addressed. Finally, practical recommendations for clinicians are provided, focusing on best practices in initial assessment, rapport building, trauma-informed care, and safe implementation of exposure techniques. Overall, the article underscores CBT’s pivotal role in PTSD treatment while advocating for flexible, culturally competent, and technologically enhanced approaches to optimize outcomes for trauma survivors worldwide. This document is a preprint of an original research article. It has been shared publicly to facilitate open access and early dissemination of findings. Please note that this work has not undergone formal peer review and should be considered preliminary. Feedback and comments from the community are welcome.