Hoarding in children is associated with more severe ancillary psychopathology, and has poor treatment outcome. At present, there are no empirically established procedures for treating hoarding in youth. The present case illustration is of a 10‐year old child (“Grace”) who presented for treatment with significant hoarding related to academic concerns and additional unrelated symptoms of obsessive‐compulsive disorder (OCD). Grace was treated with cognitive behavior therapy (CBT) primarily comprising exposure with response prevention, behavioral experiments, and cognitive therapy, along with a program of reinforcement delivered by her parents to maintain her motivation for therapy. After 23 sessions and one booster session, Grace's symptoms improved significantly, with gains maintained at 1‐year follow‐up. In addition to the benefits of the specific interventions chosen, the role of therapist–patient/parent alliance as a contributory factor for good outcome is emphasized. As hoarding is underinvestigated in youth, suggestions for further investigation are offered.