Mrs. A. presents with a textbook case of hypochondriasis. An additional diagnosis of OCD does not enhance our understanding or treatment of her problems, and is not indicated according to "DSM-IV." Cognitive-behavior therapy (CBT) is effective in treating hypochondriasis, although it is necessary to devise a case formulation for each patient to determine which interventions to use and how to best implement them. A detailed cognitive and behavioral assessment is essential to successful treatment. In this commentary, I describe the important assessment areas that need to be covered to better understand Mrs. A.'s problems and the obstacles to assessment that might be encountered. A tentative case formulation is presented, based on the available information, and a tentative CBT protocol is derived. Likely obstacles to successful treatment, such as Mrs. A.'s poor insight into her disorder, need to be more thoroughly assessed in order to devise strategies for circumventing these difficulties.