Obsessive-compulsive-like symptomatology may be present in various psychiatric disorders including schizophrenia. This has been described since Kraepelin and Bleuler. In this review, we draw attention to the often ignored notion of pseudo-obsession. The concept can add to the distinction between true obsession in OCD and related psychopathological phenomena in the schizophrenia spectrum disorders and improve diagnostic practice. The recent changes in the diagnostic manuals have made this distinction more difficult by allowing a lack of insight and delusional beliefs in the diagnostic criteria for OCD.