Obsessive-compulsive disorder (OCD) symptoms tend to be temporally stable in adults, but much less is known about their stability in young people. We examined the temporal stability of OCD symptoms in a clinical pediatric sample. As part of a naturalistic longitudinal study, 74 children and adolescents with OCD were assessed with the Children's Yale-Brown Obsessive Compulsive Scale on two separate occasions ranging from 1 to 11 years apart (average 5 years). Analysis of variance and multiple regression models examined changes within and between symptoms and symptom dimensions. Changes within individual symptom categories were observed in approximately 15-45% of the cases, depending on the specific symptom. In most of those cases, symptoms went from present to absent at follow-up rather than from absent to present. Changes were no longer significant when individuals who were in remission at follow-up were excluded. Multiple regression analyses indicated that the strongest predictor of a particular symptom dimension at follow-up was the presence of the same dimension at baseline. Shifts from one dimension to another were rare. The content of OCD symptoms is relatively stable across time in young people. Most changes observed were attributable to clinical improvement/remission and occurred within rather than between symptom dimensions.