The cosmic history of the growth of supermassive black holes in galactic centers parallels that of star-formation in the Universe. However, an important fraction of this growth occurs inconspicuously in obscured objects, where ultraviolet/optical/near-infrared emission is heavily obscured by dust. Since the X-ray flux is less attenuated, a high X-ray-to-optical flux ratio ( f x / f o ) is expected to be an efficient tool to find out these obscured accreting sources. We explore here via optical spectroscopy, X-ray spectroscopy and infrared photometry the most extreme cases of this population (those with f x / f o > 50, EXO50 sources hereafter), using a well defined sample of 7 X-ray sources extracted from the 2XMM catalogue. Five EXO50 sources (∼ 70 percent of the sample) in the bright flux regime explored by our survey ( f (2−10keV) 1.5 × 10 −13 erg cm −2 s −1 ) are associated with obscured AGN (N H > 10 22 cm −2 ), spanning a redshift range between 0.75 and 1 and characterised by 2-10 keV intrinsic luminosities in the QSO regime (e.g. well in excess to 10 44 erg s −1 ). We did not find compelling evidence of Compton Thick AGN. Overall the EXO50 Type 2 QSOs do not seem to be different from standard X-ray selected Type 2 QSOs in terms of nuclear absorption; a very high AGN/host galaxy ratio seems to play a major role in explaining their extreme properties. Interestingly 3 out of 5 EXO50 Type 2 QSO objects can be classified as Extreme Dust Obscured Galaxies (EDOGs, f 24 µm / f R 2000), suggesting that a very high AGN/host ratios (along with the large amount of dust absorption) could be the natural explanation also for a part of the EDOG population. The remaining 2 EXO50 sources are classified as BL Lac objects, having rather extreme properties, and which are good candidates for TeV emission.