Despite being a core characteristic of anxiety disorders, little data have been reported on somatic symptoms (SSs) in youth with obsessive-compulsive disorder (OCD). Eighty-five children and adolescents with OCD were administered the Children's Yale Brown Obsessive-Compulsive Scale and completed the Children's Depression Inventory and Multidimensional Anxiety Scale for Children. Their parents completed the Child Behavior Checklist and Children's Obsessive-Compulsive Impact Scale. A subset of youth (n = 62) completed a trial of cognitive-behavioral therapy. The frequency of specific SSs was examined in relation to age, gender, OCD symptom severity, child-rated symptoms of depression and anxiety, parent-proxy ratings of internalizing and externalizing problems, and functional impairment. Ninety-six percent of youth experienced at least one SS, with 67% reporting five or more SSs. Child-rated SSs were positively associated with parent-ratings of child SSs, child-rated anxiety and depression, and parent ratings of the children's internalizing problems. Parent-rated SSs were positively related to parent-proxy ratings of internalizing problems and OCD-related impairment, clinician-rated OCD symptom severity, and child-rated generalized anxiety. Total and several specific SSs were reduced following cognitive-behavioral treatment. These results suggest that SSs are prevalent in youth with OCD, are associated with symptom severity, are reduced after participation in cognitive-behavioral therapy, and warrant attention during assessment and treatment.