Obsessive-Compulsive Disorder (OCD) is a debilitating psychiatric condition characterized by obsessions and compulsions, significantly impairing functionality and quality of life. This study evaluates the effectiveness of culturally adapted Cognitive Behavioral Therapy (CBT) on symptom severity and typologies of OCD in the Kashmir region, a population uniquely affected by sociopolitical stressors and limited mental health resources. A cohort of 100 OCD patients underwent 12 weekly CBT sessions incorporating exposure and response prevention tailored to regional cultural sensitivities. Symptom severity was measured using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) pre- and post-intervention and at 6-month follow-up. Statistical analyses revealed substantial reductions in overall symptom severity (p < 0.001), with the greatest improvements in contamination and checking typologies. The study also demonstrated that shorter illness duration and higher education levels correlated with better treatment outcomes. Findings underscore CBT’s efficacy and adaptability in treating OCD across diverse symptom presentations within Kashmir’s sociocultural context. Recommendations include expanding access to culturally sensitive CBT and early intervention programs to enhance mental health outcomes in this and similar populations.