Obsessive-compulsive disorder (OCD), characterized by repetitive intrusive thoughts and ritualized behaviors, is a highly debilitating disorder with an estimated lifetime prevalence of about 2 %. Approximately 10 % of these patients have severe symptoms despite having received all available treatments, thus considered treatment refractory. Deep brain stimulation (DBS), a reversible, safe and adaptive method widely used for movement disorders, enables specific targeting of deep brain structures of relevance in OCD. About 60% of the patients with treatment refractory OCD show ameliorated symptoms and improved quality of life with DBS. Taking ethical aspects into consideration DBS is a viable option for patients with treatment refractory OCD though further studies are needed to fully understand and individualize this treatment.