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Background: Obsessive-compulsive disorder (OCD) is a multifaceted and treatable condition. We describe a patient with OCD whose main complaint was the experience of pareidolias (i.e., 'images seen out of shapes'), a symptom that responded to treatment with a serotonin reuptake inhibitor. Method: Single case report. Results: Mrs A, a 38-year-old married white woman with a history of OCD, reported visualizing faces of witches and gorillas out of floor tiles. She would see these figures without making any effort, and despite the intense discomfort associated with it, was unable to dismiss the images. Her symptoms responded to a therapeutic trial with clomipramine. Conclusion: Patients presenting typical pareidolias need to be probed for underlying OCD. This approach may have material impact on treatment decisions, with good response of the aforementioned condition to serotonin reuptake inhibitors.