El premio Primetime Emmy al mejor reality (Primetime Emmy Award for Outstanding Reality Program) es uno de los galardones Primetime Emmy. Extreme Makeover: Home Edition es el reality que ha ganado mayor cantidad de veces, consiguiendo la estatuilla en dos ocasiones.

Ganadores en negrita.

• 2001:
  • American High (FOX)
  • Taxicab Confessions (HBO)
  • The Awful Truth With Michael Moore (Bravo)
  • The E! True Hollywood Story (E!)
  • Trauma: Life In The ER (TLC)

• 2002:
  • American High (PBS)
  • Frontier House (PBS)
  • Project Greenlight (HBO)
  • Taxicab Confessions (HBO)
  • The Osbournes (MTV)
  • Trauma: Life In The ER (TLC)

• 2004:
  • Colonial House (PBS)
  • Extreme Makeover: Home Edition (ABC)
  • Penn & Teller: Bullshit! (Showtime)
  • Project Greenlight (HBO)
  • Queer Eye for the Straight Guy (Bravo)

• 2005:
  • Antiques Roadshow (PBS)
  • Extreme Makeover: Home Edition (ABC)
  • Penn & Teller: Bullshit! (Showtime)
  • Project Greenlight (Bravo)

• 2006:
  • Antiques Roadshow (PBS)
  • The Dog Whisperer (Discovery)
  • Extreme Makeover: Home Edition (ABC)
  • Kathy Griffin: My Life on the D-List
  • Penn & Teller: Bullshit!

• 2007:
  • Antiques Roadshow (PBS)
  • The Dog Whisperer (Discovery)
  • Extreme Makeover: Home Edition (ABC)
  • Kathy Griffin: My Life on the D-List (Bravo)
  • Penn & Teller: Bullshit! (Showtime)

• 2008:
  • Antiques Roadshow (PBS)
  • Dirty Jobs (Discovery)
  • Extreme Makeover: Home Edition (ABC)
  • Kathy Griffin: My Life on the D-List (Bravo)
  • Intervention (A&E Network)