OBJECTIVE: Binge eating disorder (BED) is maintained by increased food-related incentive salience, which is reflected by an attentional bias for food. Oxytocin acutely attenuates this bias in patients with anorexia nervosa and reduces food intake in males with normal or increased body weight. However, results in individuals with BED have been inconclusive. We assessed the acute effect of oxytocin on food stimulus processing and reward-driven eating behavior in females with or without BED in a double-blind, placebo-controlled cross-over study. METHOD: Females with BED (n = 48) and female control participants with overweight (n = 46) or normal weight (n = 40) received intranasal oxytocin (24 IU) and, respectively, placebo, after an overnight fast and a standardized breakfast. In participants with a natural menstrual cycle, sessions were scheduled during consecutive luteal phases. Participants completed a food-related dot-probe task with concurrent eye tracking and a bogus taste test measuring snack intake. RESULTS: Oxytocin compared to placebo increased dwell time bias on food stimuli in the BED relative to the overweight control group, in which this effect was reversed. Contrary to our hypothesis, oxytocin increased calorie intake across groups. Exploratory analyses indicated that the latter effect focused on females taking hormonal contraception. DISCUSSION: These results indicate disorder- and, respectively, sex-specific effects of oxytocin on food-related incentive salience and food intake and point to a role of oxytocin in binge eating pathology. They moreover suggest that sex hormones determine the acute effect of oxytocin on eating behavior in females.