Objective To explore the effectiveness of mindfulness-based four-step approach to obsessive compulsive disorder. Methods A total of 82 patients with obsessive compulsive disorder were divided into control group and study group with 41 cases each by admission order. The patients in control group were given routine drug treatment and nursing, and the patients in study group were given mindfulness-based four-step approach based on control group. The indexes were evaluated by Yale-Brown Obsessive Compulsive Scale, Hamilton Depressive Scale, Hamilton Anxiety Scale, Short Form 36 questionnaire before and after intervention. Results After 12 weeks treatment, the score of Yale-Brown Obsessive Compulsive Scale, compulsive thinking, compulsive behavior were (6.16 ±4.38), (3.23 ±1.93), (2.98 ± 2.01) points in study group and (10.81 ± 3.26), (6.05 ± 2.02), (4.09 ± 2.15) points in control group, and there were significant differences(t=5.386, 6.384, 2.385, all P < 0.05). The score of anxiety and depress were (1.98 ± 1.91), (2.16 ± 1.38) points in study group, and (4.05 ± 2.01), (5.11 ± 2.26) points in control group, and there were significant differences(t=4.722, 7.045, all P<0.05). The score of total life quality, physiological function, physiological function, body pain, general health, vitality, social function, emotional function, mental health were (77.32 ± 6.26), (89.11 ± 14.27), (78.19 ± 26.36), (82.33 ± 25.22), (60.18 ± 20.39), (55.31 ± 19.68), (80.13 ± 25.76), (72.13 ± 20.16), (60.12 ± 20.88) points respectively in study group, and (71.43 ± 5.62), (82.19 ± 13.36), (55.11 ± 23.27), (70.18 ± 25.71), (49.01 ± 20.13), (45.22 ± 18.11), (62.19±25.63), (45.23±23.02), (44.16±21.08) points in control group, and there were significant differences (t=2.134-6.621, all P<0.05). Conclusions The mindfulness-based four-step approach intervention can obviously relieve anxiety and depressive negativity mood in obsessive compulsive disorder patients. It can improve patient′s obsessive compulsive symptom, enhance the patient′s quality of life. It has important significance for obsessive compulsive disorder patients during their recovering period.