For pediatric patients with obsessive-compulsive disorder, clinicians must address particular diagnostic and treatment challenges. Children with obsessive-compulsive disorder may have little insight into their obsessions and compulsions, requiring clinicians to provide age-appropriate education, motivation, and therapy. Treatment should take into account children’s developmental level, family accommodation, and comorbidities. If the onset of obsessive-compulsive disorder is sudden, clinicians may use pediatric acute-onset neuropsychiatric syndrome criteria and conduct appropriate tests.