Aim This study aimed to contribute to the paucity of literature on disability in youth with OCD, particularly in low‐ and middle‐income countries (LMICs). Methods In South Africa (a LMIC), data was collected from 26 children and adolescents with OCD (12 girls, 14 boys; age range 6–18 years), and their parents, on an outpatient basis. Clinical measures aimed at assessing functional impairment due to OCD were administered. Results Key findings were 1) that children with OCD reported being most significantly affected by their OC symptomatology within the school domain whereas parents placed emphasis on the impairment within the social domain; 2) scores on the Child Obsessive–Compulsive Impact Scale – Revised and the Children's Global Assessment Scale, were consistent, and 3) clinician‐rated symptom severity was positively associated with parental reports on children's impairment due to OCD. Findings show similarities with data from similar studies in a high‐income country (HIC) context. Conclusions Children with OCD and their parents do not necessarily agree on the ways in which OCD impacts their lives. A comprehensive view of functional impairment in children with OCD, that is, from the viewpoints of the patient, parents, and clinicians, is critical when treatment is planned. Such information may assist with selection of relevant treatment targets, and ultimately improve the quality of life of all affected.