Pathological skin picking (PSP) is a disabling disorder characterized by repetitive picking of the skin that causes tissue damage. Estimated to affect 2% to 5.4% of the population, PSP is currently listed as an impulse control disorder not otherwise specified. However, the repetitive and compulsive behaviors seen in PSP are phenomenologically and clinically similar to the behaviors seen in obsessive-compulsive disorder and other body-focused repetitive behaviors, such as trichotillomania and pathological nail biting. Animal neuroimaging research in related disorders such as obsessive-compulsive disorder and trichotillomania provides useful information for understanding PSP. Recent cognitive testing of individuals with PSP demonstrated impaired inhibitory control; these findings may assist in the proper characterization of PSP and aid in the development of effective treatment options. Although the disorder is common, appropriate treatments for PSP are limited. Pharmacotherapeutic and certain cognitive-behavioral interventions have demonstrated promise in treating this disorder and need to be explored further.