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Perfectionism has a well-established relation with mental health concerns, notably depression and suicidal ideation (SI) severity. Previous research has also shown perfectionism is associated with diminished treatment gains; however, nearly all analyses on this topic are derived from a single dataset at the outpatient level. Our aim was to examine whether perfectionism and its dimensions, as assessed by the Big Three Perfectionism Scale-Short Form (BTPS-SF), are associated with improvements in depression and SI symptom severity during a transdiagnostic partial hospital program (PHP). We analyzed perfectionism scores at baseline and depression and SI scores at baseline and discharge from N = 738 adult patients attending a PHP. The total perfectionism score, and the self-critical and rigid perfectionism dimensions, were significantly associated with baseline depression and SI scores. The total perfectionism score, and the self-critical perfectionism dimension, were significantly associated with diminished treatment gains in depression and SI symptom severity from baseline to discharge. Our results suggest that perfectionism is associated with the baseline severity of psychopathology, specifically depression and SI severity, and may inhibit therapeutic gains. This study expands the existing literature on perfectionism's deleterious relation with psychopathology and treatment effectiveness to more acute levels of care. Clinicians may wish to consider screening for perfectionism and potentially addressing it as a target of treatment.