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Attention bias modification (ABM) therapy aims to reduce anxiety by changing threat-related attention patterns using computerized training tasks. We examined changes in brain microstructure following ABM training. Thirty-two participants were randomly assigned to one of two training conditions: active ABM training shifting attention away from threat or attention control training involving no attention modification. Participants completed six lab visits, including five training sessions and three diffusion tensor imaging scans: immediately before and after the first training session, and at the end of the training series. Indices of local and global changes in microstructure and connectivity were measured. Significant longitudinal differences in fractional anisotropy (FA) between the active and control training regimens occurred in inferior temporal cortex. Changes in FA occurred across groups within ventromedial prefrontal cortex and middle occipital gyrus. These results indicate specific effects of active ABM on brain structure. Such changes could relate to clinical effects of ABM.