Abstract
Musical obsessions are a form of involuntary musical imagery that may occur in the context of obsessive-compulsive disorder and patients presenting with this symptom are usually in their early adulthood. This case highlights the unusual presentation of musical obsessions in an elderly patient and the subsequent evaluation and treatment given. It is important to recognize and distinguish this from other symptoms such as auditory hallucinations with musical content and palinacousis as this will affect the subsequent clinical assessment and management required.