IntroductionStudies suggest that metacognitive therapy (MCT) is a promising treatment for pediatric OCD, but less is known about its mechanisms and effects in light of comorbid disorders. The aim of this study was therefore to explore the magnitude of effects, response and remission rates, and trajectories of change associated with MCT for pediatric OCD in a sample presenting both with and without comorbid neurodevelopmental and anxiety disorders.MethodsIn total, 37 participants aged 9–17 years