Obsessive-compulsive disorder (OCD) is characterized by the presence of unwanted, intrusive thoughts coupled with ritualized behaviors intended to reduce subjective anxiety. Although once considered a homogeneous disorder, recent findings support a view of OCD as consisting of symptom subtypes. Additionally, there has been increased interest in the contribution of disgust to various forms of psychopathology. The present article summarizes the available literature on contamination-based OCD with an emphasis on the role of disgust as it pertains to the etiology and maintenance of this form of OCD. We propose an updated model of contamination-based OCD that accounts for the elevated disgust response observed in individuals with this form of OCD. Treatment implications of a disgust-based model of the disorder are discussed in the context of cognitive-behavioral therapy.