Objectives: The aim of the study was to comparing the efficacy of transdiagnostic CBT VS pharmacotherapy on reducing severity of OCD patients with co-occurring anxiety and mood disorders. Design: Sample of 36 patients recruited from 4 psychiatric and psychological centers from Zanjan, Iran. The participants assigned randomly on three groups (TCBT, Pharmacotherapy, and Control). Setting and conduct: Psychological instruments was administrated in four episodes: pretest, midtest, posttest, and a month follow up by two trained professional assistants. The instruments included clinical severity scale from Anxiety Disorders Interview Schedule for DSM-IV (ADIS) and self-reported diagnosis-specific scales. Participants: Qualified criteria for the sample included a principal diagnosis of OCD, an age requirement of 18 years or more, and confirm the informed consent. Exclusion criteria included the presence of any clinical conditions comprised current DSM-IV diagnosis of psychotic disorders, bipolar disorder, recent history of substance abuse, cognitive and personality disorders and absented in two and more psychotherapeutic sessions and drug cessation across implementing the study. Intervention: Psychological interventions was contained 20 session 1 hour based on Barlow UP, and pharmacotherapy was included SSRIs drugs that prescribed by psychiatrist. Control group didn't receive any intervention. Main outcome measures: OCD severity, frequency, and dimensions from principle diagnose and anxiety, depression, worry, and social anxiety scores from comorbid diagnosis were included in main outcome measures.