This paper presents a cognitive behavioural perspective on factitious disorder. The DSM-IV definition will be given and aetiological and epidemiological information will be presented, whilst noting the difficulty in collecting data from this group. The difficulty in engaging the patient will be addressed. In assessing the patient, the role of early experiences, the beliefs about their feigning of symptoms, the gains from this behaviour and the reaction of others will be considered. The similarities with somatization and malingering will be discussed. A model of this disorder based on the Beckian approach will be given as will an explanation of why this disorder may become chronic. A treatment strategy will be suggested looking at helping the patient understand their disorder, discussing with them the pros and cons of alerting others to their feigning behaviour, helping them get their needs met in a more appropriate way, looking at the risks involved in the behaviour, and addressing issues of abuse.