This study aimed to compare metacognitive beliefs and cognitive emotion regulation strategies between individuals with obsessive-compulsive disorder (OCD) and their healthy controls. The statistical population comprised all women with OCD referred to the psychiatric emergency unit of Razi Hospital in Maragheh, Iran, in 2025. A sample of 60 participants (30 individuals with OCD and 30 healthy controls) was selected using convenience sampling. Data were collected using the Maudsley Obsessive-Compulsive Inventory (MOCI), the Metacognitions Questionnaire-30 (MCQ-30), and the Cognitive Emotion Regulation Questionnaire (CERQ). The findings revealed no significant differences between the OCD group and their healthy controls in the scores of refocus on planning, positive reappraisal, positive refocusing, acceptance, and perspective-taking (P > 0.05). However, significant differences were observed between the two groups in the scores of catastrophizing, rumination, other-blame, and self-blame (P < 0.01). Additionally, statistically significant differences were found between the OCD group and their healthy controls in the scores of uncontrollability and danger of thoughts, cognitive awareness, cognitive confidence, and need to control thoughts (P < 0.01). Individuals with OCD exhibit more maladaptive metacognitive beliefs and more dysfunctional emotion regulation styles compared to their healthy counterparts. It can be concluded that maladaptive metacognitive beliefs and dysfunctional emotion regulation strategies serve as discriminating variables between the OCD group and their healthy controls and may be considered in clinical diagnosis.