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Several psychotherapy models for borderline personality disorder (BPD) have demonstrated efficacy in randomized controlled trials (RCT). However, these treatment models were developed in Western countries and have seldom been evaluated in non-Western countries, such as Iran. Dynamic deconstructive psychotherapy (DDP) is a weekly individual psychotherapy that has demonstrated efficacy in clinical trials, but its efficacy has never been tested by an independent research group outside of the United States. In the present study, 30 participants diagnosed with BPD were randomly assigned to either 12 months of DDP, or to enhanced usual care (EUC), and then followed naturalistically for an additional 3 months. The primary outcome was symptom severity of borderline personality disorder. Secondary outcomes included maturity of object relations, level of personality organization, and depressive symptom severity. Results indicated that in the intent-to-treat sample, participants receiving DDP demonstrated a large and statistically significant reduction in BPD symptom severity relative to those receiving EUC. The difference in outcome was sustained after ending treatment during the naturalistic follow-up period. Improvement in BPD severity from beginning DDP to follow-up was nearly two standard deviations (d = 1.93), with 80% retention. DDP demonstrated medium to large effects on improvement of secondary outcomes. The results of this study suggest that this therapeutic model may effect changes in both symptoms and personality structure that are sustained over time, and may be used for individuals across different cultures, backgrounds, and languages.