Background: Paranoia is an important psychiatric symptom with an important effect on daily life. Virtual reality (VR) based treatments are suggested as an effectual treatment for patients with paranoia, facilitating learning. To our knowledge, there is a lack of systematic reviews to evaluate VR-based treatment as a treatment for paranoia or paranoid delusions. This study aimed to review reports that investigate VR-based treatment as a treatment for patients with paranoia.Methods: Studies published up to 20/07/2020 about VR-based interventions for the treatment of patients with paranoid delusions or paranoia were reviewed in five databases including PubMed, Embase, Web of Science, PsycINFO, and Scopus.Results: From the total of 252 initial searches, 6 were included in the study based on inclusion criteria. Four studies were performed as randomized controlled trials and two were before-after studies. All of them showed positive results in the main target, including increased social participation, reduced anxiety, and suspicious ideas and paranoid symptoms. Conclusion: VR-based interventions are effective treatments. Although the use of VR technology is limited for a variety of reasons, including the cost, it improves symptoms in patients with paranoia.