Obsessive-compulsive disorder (OCD) often emerges during childhood, presenting as distressing obsessions and compulsions that interfere with daily functioning. Advanced paternal age (APA) introduces unique psychosocial dynamics within families, potentially exacerbating stress, anxiety, and intergenerational emotional challenges. This case report examines the presentation of OCD in a 10-year-old boy, characterized by pervasive death anxiety shared with his 83-year-old father, whose advanced age intensifies existential concerns. The report delves into the complex interplay between APA, the child's obsessive-compulsive symptoms, and family dynamics marked by a dichotomy of the mother's enmeshment and the father's emotional distancing. Cultural considerations also play a critical role, as the mother's Filipino heritage introduces unique values and practices that influence caregiving dynamics and coping mechanisms. Therapeutic strategies tailored to this multifaceted context are explored, focusing on alleviating OCD symptoms, strengthening family cohesion, fostering open dialogue about existential fears, and addressing culturally sensitive aspects of care. This case underscores the critical need for personalized and culturally attuned interventions that address the psychosocial challenges associated with APA, highlighting their profound impact on pediatric mental health outcomes.