Background: There is an important relationship between perfectionism (P), body dissatisfaction (BD) and eating disorders (ED). Objective: To describe the evidence about P and/or BD within the clinical course of ED. Method: A review of specialized textbooks and the available literature in PubMed was made. Two descriptive case reports are analyzed. Results: Socially prescribed and self-oriented dimensions of P were related to ED attitudes and specially restrictive behaviors, mediating and moderating the association between BD and ED. BD and P are intrapersonal risk factors in the development of an ED. BD shares about 10% of genetic variability with P and both increase the appearance comparative assessment, mainly within a higher western acculturation, drive for thinness, a maladaptative stress response, a low self-esteem, the severity of the disorder, depressive symptomatology, sports that emphasize a slim body shape, comorbidities (personality, anxiety and/or affective disorders), alexithymia and lack of assertiveness. Conclusions: According to the evidence, BD and P, although unspecific, are core characteristics of ED as predisposing, triggering and/or perpetuating factors that significantly influence its treatment and outcome.