Objective: Neurofeedback (NF) is gaining recognition as an evidence-based intervention grounded in learning theory, and 19-channel z-score NF (19ZNF) is a new NF model. This pilot study sought to evaluate the efficacy of 19ZNF in a clinical setting. Method: Outcome measures framed groups such that 19ZNF was evaluated, as it relates to the neuropsychological constructs of attention (n = 10), executive function (n = 12), behavior (n = 14), and electrocortical functioning (n = 21). One-tailed t tests compared pre–post difference scores. Results: For all pre–post comparisons, the direction of change was in the predicted direction, and differences were statistically significant (p = .000 to p = .008, effect sizes 1.29 to 3.42). Conclusion: Results suggest 19ZNF improved attention, executive function, behavior, and electrocortical function. This study provides beginning evidence of 19ZNF’s efficacy, adds to what is known about 19ZNF, and offers an innovative approach for using quantitative electroencephalographic (QEEG) metrics as outcome measures.