A significant number of people diagnosed with BPD experience emptiness. Service-users report that feelings of emptiness are intolerable, terrifying, and debilitating, and research shows that it is contributory to self-harming and suicidal behaviors including completion of suicide. Yet this criterion seems to be the least investigated of any of the nine criteria. This chapter examines what ‘emptiness’ is and whether current research reflects necessary and sufficient conditions for the concept. I describe prevailing thinking on the development of BPD and emptiness. The chapter then turns to experiences of emptiness that are found in other diagnoses, everyday life, and cross-culturally. I suggest that not all experiences of emptiness are signs of pathology. The second half of the chapter focuses on treatment possibilities, focusing on people diagnosed with BPD. I set out the main ideas in Dialectical Behavioral Therapy (DBT) and then work with one of the core methods in DBT for skill-building—mindfulness—to argue that some service-users may benefit from practicing Buddhist meditation. I conclude by discussing and responding to critics of such a position, after which I emphasize that Buddhist meditation is not for everyone and is only one option for treatment of feelings of emptiness.