Client gift giving is an interesting interpersonal event, and scholars have considered the ethical and clinical complexities involved in receiving gifts from clients. Attention to the cultural relations of client gift giving invites a more nuanced discussion of psychologists' decisions to accept or decline client gifts. In recognition of how cultural issues affect the therapeutic relationship, the American Psychological Association has instituted guidelines regarding multicultural competence and has urged psychologists to practice in a culture-centered manner. This article reviews the ethical decision making of 40 licensed psychologists to accept or decline gifts from clients. Results indicated that psychologists were more likely to accept gifts from clients when the gift was inexpensive, informed by cultural context, and presented with gratitude for good work at the end of psychotherapy treatment. Psychologists were more likely to decline gifts that were expensive, were presented during treatment rather than at the end of treatment, and had sentimental or coercive value. Two psychologists indicated they would not accept client gifts because they perceived gift acceptance to be a violation of their code of ethics.