Cognitive behavioral therapy (CBT) produces robust effects in treating a variety of youth mental health concerns, yet there have been concerns about its cultural compatibility for ethnic-racial minoritized (ERM) youths. Cultural adaptation of CBT can address these concerns by systematically modifying treatment to better align with the cultural beliefs, values, and practices of ERM youth clients. Clinicians working with ERM youth clients must make conscientious decisions about whether, when, and how to culturally adapt CBT. This chapter describes a dynamic, five-step process for culturally adapting CBT: (1) planning to use unadapted CBT, unless otherwise indicated; (2) continuously assessing whether/when to culturally adapt CBT; (3) determining how to culturally adapt CBT; (4) implementing the cultural adaptation; and (5) evaluating the effect of the cultural adaptation. A fictionalized case example is provided to illustrate how this process can be applied in clinical practice, highlighting the importance of treatment integrity and cultural responsiveness in achieving successful treatment outcomes.