This chapter explores therapeutic alliance and rupture repair in couple and family cognitive-behavioral therapy, diving into the nuances of building and sustaining alliance in multi-participant treatment where the client is identified as a family or couple rather than an individual. When it comes to alliance in couple and family therapy (CFT), each person develops a therapeutic relationship with the therapist and observes the relationship between the therapist and other family members developing over time. In other words, each alliance is observed and influenced by others. Moreover, therapists are tasked with building a shared sense of purpose and alignment on goals across family members who may have differing needs and motivations for treatment. These aspects of alliance are unique to CFT and require systemic interventions. We introduce findings from research on how the alliance affects clinical outcomes and retention in treatment and review methods for monitoring alliance in CFT. We then summarize clinical strategies for building individual and systemic alliances, review common alliance ruptures and pitfalls in CFT, and recommend techniques for alliance repair. Core to these interventions is developing system-oriented goals meaningful to all treatment participants to bring all participants into the process of learning and practicing new behaviors so that positive changes can be made. Sociocultural attunement is addressed throughout the chapter, for example, considering power dynamics inherent in treatment. We conclude with clinical case examples and vignettes illustrating the techniques described throughout the chapter with commentary providing insight into clinical application.