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Obsessive-compulsive disorder (OCD), a common complex psychiatric illness with a 2% lifetime prevalence rate is high-lighted by World Health Organization (WHO) as one of the top 5 disabling illnesses in the world. Its treatment was the focus of formal guidance from National Institute for Clinical Excellence (NICE) in 2005. Despite the increased focus on treatment of OCD, it is an area that is often misunderstood and undertreated. It is particularly tragic as OCD is surprisingly easy to treat and amenable to both psychological and psychopharmacological treatment. This review examines the important changes that have taken place in the psychological and psychopharmacological treatments for OCD in recent years. How these treatments may be delivered using the framework of NICE guidance will also be discussed. Finally the review will examine current experimental treatments and possible future developments in the management of patients.