Individualized photorealistic environments for exposure therapy can be readily created using 360° panoramic movies recorded with a consumer-quality camcorder. These panoramic movies are presented on a head-mounted display equipped with a position-tracking device to enable looking around the virtual environment. To demonstrate the treatment efficacy of this individualized virtual reality exposure therapy using 360° panoramic movies, we report a case study of the treatment of a 13-year-old male with severe fear and avoidance of heights. We made panoramic movies of situations where he reported fear, and presented them on a head-mounted display. A total of 8 exposure sessions were conducted over a period of 9 weeks. All his self-report measures of fear and avoidance of heights decreased as the treatment progressed, and were maintained at a 7-month follow-up.