Background: Body dysmorphic disorder (BDD) involves an excessive preoccupation with a perceived or minor physical flaw, significantly affecting mood and daily functioning. Typically starting in adolescence, BDD leads individuals to spend 3 to 8 hours, or more, daily fixating on disliked body parts, with these obsessions being hard to control and causing substantial anxiety and distress. Objective: To find out the effect of cognitive restructuring activities to reduce anxiety among body dysmorphic adolescent girls. Materials and methods: This study was done among college students of the late adolescent age group between 18 and 20 in St. Joseph’s Hospital. A total of 30 BDD adolescent girls were selected according to inclusion and exclusion criteria. The subject’s anxiety level was measured using Hamilton’s anxiety scale (HAM-A) to get pre-test values. Then the samples were divided equally, 15 samples in the control group and 15 samples in the experimental group. The experimental group underwent cognitive restructuring activities and the control group underwent conventional occupational therapy. Post-test was conducted after the study period of 3 months using Hamilton’s anxiety scale. Results: The study's results indicated a significant p-value of 0.001, demonstrating that cognitive restructuring techniques were effective in reducing anxiety among body dysmorphic adolescent girls. Conclusion: The results suggested that cognitive restructuring activities given to the experimental group were effective and the level of anxiety decreased after the intervention.