Purpose of Review <p>The paper provides a brief expert overview of key findings in research that has advanced understanding of the phenomenology, underlying mechanisms, assessment, and treatment of childhood OCD.</p> Recent Findings <p>There have been advancements in the phenomenology and underlying mechanisms. For instance, OCD presentations are being studied in more diverse populations resulting in new insights regarding OCD symptom pathogenesis (e.g., genetic and epigenetic markers). Additionally, there has been a greater recognition of the role of avoidance and accommodation behaviors in the phenomenology of childhood OCD. Furthermore, studies have identified the critical role that extinction learning plays in the development and treatment of childhood OCD. There have been advancements in the assessment of OCD that have resulted in the refinement of measures to incorporate improved phenomenological understanding and optimize sensitivity to detect OCD symptoms in everyday clinical practice. In regard to treatment advancements, there has been considerable progress made towards increasing the accessibility of CBT using telehealth platforms. There remains a need for further research on neuromodulation and evidence-based approaches for treating childhood OCD cases that do not respond to CBT and/or evidence-based pharmacotherapy.</p> Summary <p>Several advancements have been made in multiple areas of understanding phenomenology, underlying mechanisms, assessment, and treatment of childhood OCD. However, additional efforts are warranted to obtain deeper understanding of genetic factors, treatment non-response, and additional treatment options for refractory cases.</p>