Obsessive-compulsive disorder (OCD) is a common and poorly diagnosed disorder that has a significant negative impact on the functioning and quality of life of the patients. There are a number of controversial issues regarding the diagnosis and treatment of OCD that have not yet been fully resolved. This publication discusses the diagnostic boundaries of OCD and OCD spectrum disorders, differential diagnosis, and modern approaches to OCD treatment based on the principles of evidencebased medicine. The data on all the main therapeutic approaches are presented – psychopharmacotherapy, psychotherapy, non-drug biological methods of therapy. The use of selective serotonin reuptake inhibitors as the first line of therapy for OCD is substantiated. In conclusion, the publication summarizes the main errors and difficulties associated with the management of patients suffering from obsessive-compulsive disorder. © 2024, IP Kostyukova Elena Grigorievna. All rights reserved.