Recent decades have seen the growth of an extensive literature reassessing the nature and role of unconscious fantasy. While this literature represents a wide range of psychodynamic theories, some consistent themes have emerged: A comprehension of unconscious fantasy as a pervasive molder of all perception and meaning; a recognition of the stabilizing, anxiety-damping role of unconscious fantasy; a valuation of symptoms as the maladaptive intrusion of unconscious fantasy into everyday life; and a view of progress in psychotherapy as entailing modifications in the structure and/or penetrance of dominant fantasies. The broad-based interest in unconscious fantasy reflects a wide consensus that a focus on unconscious fantasy promises to establish a more solid epistemological foundation for psychodynamic theory, to relate more immediately psychodynamic theory to clinical observation, including providing more incisive and comprehensive insights into motivation, and to yield a more profound understanding of the nature of the therapeutic process and the dynamics of psychological growth. While there is some consensus on the ineluctable molding of perception and memory by unconscious fantasy, questions remain concerning the relationship of an event to its psychological integration, most notably questions regarding to what extent particular traumas yield distinctive patterns of fantasy and pathology. Further answers to these questions will provide deeper insights into how fantasy shapes our path through the world and how that path may be redirected by psychotherapy.