Patients with health anxiety often present challenges to assessment and treatment planning. The case of Mrs. A. provides examples of several clinical issues common to these patients. Her symptoms cross several "DSM" diagnostic categories, with a primary presentation of hypochondriasis and secondary presentation of illness phobia. In this article, we detail our approach to case conceptualization, outline assessment strategies, and consider treatment options and strategies. Specific attention is given to the challenge of having Mrs. A. willingly explore the possibility that her bodily signs and sensations are better accounted for by explanations other than physical disease.