Obsessive Compulsive Disorder (OCD) is a mentally debilitating condition that can present in a multitude of ways and its manifestations can vary within the diagnosed patient population. OCD can be diagnosed with the presence of either obsessions or compulsions and does not require both. Sometimes, OCD can affect a patient in a way that mimics delusional misidentification syndromes. In these cases, a patient\u27s ego-dystonia can be a key distinguishing feature in diagnosis. In one specific delusional misidentification syndrome, Capgras, a patient possesses fixed beliefs that a known person (or sometimes object) is an imposter. And even though the textbook OCD presentation differs from that of Capgras Delusion, there can be overlapping similarities. As such, a patient\u27s insight and ego-dystonia into these preoccupations may help to point the diagnosis towards an obsessional form of OCD, a critical recognition for proper treatment. This case will highlight the importance of recognizing the distinction between obsessions and delusions to appropriatelv treat a patient with OCD with primarily obsessions
