Despite the substantial impairments in life functioning associated with obsessive-compulsive disorder (OCD), treatment outcome evaluations have focused almost exclusively on symptom reduction, a focus that may be too narrow to determine whether clinically significant change has occurred. Quality of life (QOL) impairment was evaluated in a clinical OCD sample (N = 188) using a multidimensional life satisfaction measure. Refaionships between treatment response and QOL change also were evaluated with a subsample of participants (n = 120). Congruent with previous studies of OCD, substantial pretreatment QOL impairment was found across all life domains. Distinct treatment change subgroups were identified: a group reporting strong symptom reduction and very good QOL gains, a second group with significant symptom reduction but less robust QOL improvements, and a third group with limited symptom gains and QOL decreases. Implications for understanding OCD-related impairment and the clinical significance of treatment outcomes are discussed.