Obsessive compulsive disorder (OCD) is a frequent condition. First-choice psychopharmacological treatment includes SSRIs where the choice of drug depends on the occurrence of side effects. If remission is obtained, continued treatment is recommended for at minimum of one year. If only a partial or no response is obtained, augmentation treatment with atypical antipsychotics may be attempted. However, only few studies have examined the effect and side effects of augmentation treatment in children and adolescents. The aim was to provide a summary on the current knowledge on psychopharmacological treatment of children and adolescents with OCD.