Most obsessive-compulsive disorder patients get sick in childhood, adolescence and early adulthood, which has a serious impact on their psychosocial function. Childhood and adolescence are critical period of neurological development. Affected by genetic and environmental factors, individuals often have neuronal damage, abnormal myelination, synaptic overpruning, abnormal synaptic connections and so forth. Pediatric obsessive-compulsive disorder is closely related to neurodevelopmental, which may involve genetic variation, immune activation, neurotransmitter disorders and functional and structural abnormalities of key brain regions in the cortico-striato-thalamo-cortical.With the development of neuroimaging, optogenetics and other advanced technologies, the dynamic development process of the brain has been further understood, and the etiological mechanism of pediatric obsessive-compulsive disorder has been further explored.This paper summarized the latest researches in this field, focusing on neurodevelopment, and expounds the possible pathophysiological mechanism of obsessive-compulsive disorder from the perspectives of neuroimmunology, neurostructure, neuroimaging, neurobiochemistry and other disciplines. It provides a new idea for the early accurate diagnosis, recognition and intervention of obsessive-compulsive disorder.