Objective: To study the phenomenology, treatment, course, and outcome of patients with comorbid obsessive-compulsive disorder (OCD) and psychotic features. Method. A retrospective chart analysis was conducted on 15 patients with OCD with psychotic features. Data were collected regarding patient demographics, psychiatric diagnosis, duration of illness, treatment details, and clinically determined outcome over time. Results: Obsessive doubts, washing, and checking compulsions were the most commonly seen obsessive-compulsive (OC) symptoms. Of the patients, 53% had first-rank symptoms, and 77% showed significant improvement on treatment with a combination of antipsychotic and antiobsessional drugs. Conclusions: The observed improvement on treatment with a combination of antiobsessional and antipsychotic drugs supports the use of combination treatment in patients who have both OC and psychotic symptoms.