Introduction: Disability to recognize emotions in children with autism will cause their aggressive behaviors against themselves and others, which brings about weakening of social interaction and psychological problems. Therefore, this study was conducted to determine the effect of sand play therapy with a cognitive-behavioral approach on the reduction of emotional recognition problems and social growth in boys with autism spectrum disorder. Materials and Methods: This was a semi-experimental study with pre-test, post-test, and followup. Boys with autism spectrum disorder with high performance admitted to the Ehya autism center in Tehran in 2019 formed the statistical population of the study. A number of 30 individuals were selected by available sampling and they were randomly assigned to two experimental and control groups. Data were collected by Gilliam autism rating scale, Matson social skills questionnaire, and Benton facial recognition test. In the experimental group, the treatment program was performed in 8 sessions, 1 session per week and each session for 1 hour, but the control group did not receive this treatment. Data were analyzed using analysis of variance with repeated measures. Results: The results showed that the level of social growth (η, =0. 543, p=0. 007, F=7. 36) and Emotional recognition (η, =0. 609, p=0. 005, F=22. 12) of the experimental group increased significantly compared to the control group and this increase was remained steady in the follow-up. Conclusion: Based on the findings of this research, sand play therapy with a cognitive-behavioral approach can be used as an effective intervention method to improve the emotional and social status of people with autism.