The etiopathogenesis of obsessive-compulsive disorder (OCD) remains elusive. Clinical observation of the elevated frequency of obsessive-compulsive symptoms in patients with rheumatic fever, a post-streptococcal autoimmune disease, prompted the study of immune parameters in OCD. Anti-basal ganglia antibodies have been described in a subset of OCD patients. The assessment of circulating cytokines and immune cells confirmed unequivocal changes in at least some patients, although it is difficult to establish a particular immune profile in OCD. Several factors, including the use of psychotropic drugs and the presence of comorbid conditions, seem to influence these immune parameters.