Problematic pornography use (PPU) is a complex clinical phenomenon increasingly addressed in the context of compulsive sexual behavior disorders (CSBD), introduced in the ICD-11 classification. The literature emphasizes that PPU is associated with loss of control over sexual behavior, emotional dysregulation, reduced quality of life, and significant psychological distress, with no clear diagnostic criteria or treatment standards. Cognitive-behavioral therapy (CBT) is currently the most widely described and best documented form of intervention for PPU, encompassing both classic second-wave CBT techniques and newer third-wave approaches such as acceptance and commitment therapy (ACT) and mindfulness-based interventions. Available studies suggest that CBT interventions lead to a significant reduction in the frequency of pornography use, sexual compulsivity, and internalizing symptoms, as well as improvements in self-control and emotional regulation. Particularly promising results are obtained in programs that integrate elements of acceptance and mindfulness, which promote greater consistency between behavior and personal values and reduce moral incongruence. A growing body of evidence also points to the effectiveness of online CBT as an alternative to traditional forms of treatment, especially among individuals who avoid direct contact with a therapist due to shame or fear of stigmatization. Limitations of existing research include small sample sizes, a predominance of male participants, and a lack of uniform criteria for assessing effectiveness. Further well-designed studies involving diverse patient groups and comparing different CBT interventions are needed. Overall, available evidence indicates that cognitive-behavioral therapy, in both traditional and remote formats, remains the most empirically justified therapeutic approach for problematic pornography use.