Child and adolescent obsessive–compulsive disorder (OCD) is a chronic and debilitating condition associated with a wide range of impairments. This article briefly discusses the phenomenology of OCD, the theory underlying current treatment approaches, and the extant psychosocial treatment literature for child and adolescent OCD relative to the criteria for classification as an evidence-based intervention. Studies were evaluated for methodological rigor according to the classification system of Nathan and Gorman ( 2002 Nathan , P. E. , & Gorman , J. M. ( 2002 ). A guide to treatments that work () , 2nd ed. . New York : Oxford University Press . [Google Scholar] ) and then were assessed relative to the criteria for evidence-based treatments specified by Chambless et al. ( 1998 Chambless , D. L. , Baker , M. J. , Baucom , D. H. , Beutler , L. E. , et al. . ( 1998 ). Update on empirically validated therapies, II . The Clinical Psychologist , 51 , 3 – 16 . [Google Scholar] ), Chambless et al. ( 1996 Chambless , D. L. , Sanderson , W. C. , Shoham , V. , Johnson , S. B. , Pope , K. S. , et al. . ( 1996 ). An update on empirically validated therapies . The Clinical Psychologist , 49 , 5 – 18 . [Google Scholar] ), and Chambless and Hollon ( 1998 Chambless , D. L. , & Hollon , S. D. ( 1998 ). Defining empirically supported therapies . Journal of Consulting and Clinical Psychology , 66 , 7 – 18 . [Crossref], [PubMed], [Web of Science ®] [Google Scholar] ). Results from exposure-based cognitive behavioral therapy (CBT) trials with children and adolescents have been consistent, with remission rates of the disorder ranging from 40% to 85% across studies. Findings from this review indicate that individual exposure-based CBT for child and adolescent OCD can be considered as a probably efficacious treatment. CBT delivered in a family-focused individual or group format can be considered as a possibly efficacious treatment. Moderators, mediators, and predictors of treatment outcome are discussed, as are implications and generalizability of extant findings to real-world settings. We conclude with recommendations for best practice and future research directions.