Obsessive Compulsive Disorder (OCD) is an anxiety disorder, characterized by repetitive unwanted obsessions and compulsions, with a prevalence of 0.5-1% to 4% in childhood and adolescence. The exact pathogenesis of OCD remains uncertain but multiple components such as hereditary/genetic, cognitive, biological, environmental and behavioral factors have been implicated. The aim of this review is to highlight the pathogenesis of OCD in childhood and adolescence, differentiate it from adult onset OCD and outline its assessment and management.