Background: Worldwide, refugees and asylum seekers suffer at high rates from trauma- and stress-related mental health problems. We thus developed Mindfulness-Based Trauma Recovery for Refugees (MBTR-R) – a 9-week, mindfulness- and compassion-based, trauma-sensitive and socio-culturally adapted, group intervention for refugees and asylum seekers. Aims: We assessed whether MBTR-R is an efficacious and safe mental health intervention for traumatized asylum seekers. Method: We conducted a randomized waitlist-control trial of MBTR-R among a community sample of 158 Eritrean asylum seekers (46.2% female, 53.8% male) with severe trauma history and ongoing post-migration stress. Results: Eighty-three of 98 participants randomized to MBTR-R and 48 of 60 randomized to waitlist-control condition were prospectively retained and completed pre- and post-intervention assessment. Relative to waitlist-controls, MBTR-R intervention completers (> 4 sessions attended) demonstrated significantly reduced rates and symptom severity of PTSD, depression, anxiety and multi-morbidity – at post-intervention and at 5-week follow-up; as well as improved well-being at post-intervention, but not follow-up. Intent-To-Treat sample effects were identical, though smaller in magnitude. Second, intervention effects were not dependent on key demographic factors, post-migration living difficulties or trauma history severity. Finally, no MBTR-R participant demonstrated lasting clinically significant deterioration in any of the monitored symptoms or well-being. Importantly, MBTR-R appears to be efficacious and safe for highly traumatized and chronically stressed asylum seekers in an urban post-displacement setting. High attendance and low study attrition suggest that MBTR-R may be a feasible and acceptable mental health intervention among asylum seekers. Due to its brief intervention format and group-based delivery, MBTR-R may be readily implemented and well-suited for scaling. Considering fast-growing human rights and mental health crisis of forced displacement, and extensive barriers to mental health intervention delivery among refugees and asylum seekers, observed MBTR-R efficacy and safety are promising.