Purpose of Review <p>This narrative review examines neuromodulation as a potential augmentation strategy for cognitive-behaviour therapy (CBT) with exposure and response prevention (ERP) in obsessive-compulsive disorder (OCD). By synthesising behavioural, neurobiological, and clinical literature, we evaluate how circuit-based interventions can enhance extinction learning (EL), the core mechanism of ERP, and improve outcomes.</p> Recent Findings <p>ERP is the gold-standard treatment for OCD, yet a substantial proportion of patients do not respond adequately or drop out. EL, driven by habituation, inhibitory memory formation, and expectancy violation underpins ERP. EL is often impaired in OCD, linked to cortico-limbic dysfunction. Of note, ventromedial prefrontal cortex (vmPFC) plays a central role in extinction memory formation as well as retrieval, and hence, can be considered as the central “extinction locus”. Non-invasive neuromodulation techniques have shown preliminary efficacy in modulating these circuits. Preclinical studies show that stimulation of vmPFC before or during exposure may enhance EL. However, conventional methods may not be adequate to stimulate deeper structures such as the vmPFC. Novel focal and noninvasive neuromodulatory techniques, such as transcranial focused ultrasound or temporal interference stimulation, have to be evaluated. Cognitive domains beyond extinction, including working memory, error monitoring, and distress tolerance, also represent promising neuromodulatory targets.</p> Summary <p>Neuromodulation offers a promising, circuit-based approach to augment ERP in OCD by strengthening EL and related processes. Future progress requires focal, personalised, and mechanistically guided protocols.</p>