An analysis of the exact bit error rate (BER) performance of orthogonal space-time block codes (OSTBCs) with maximum-likelihood detection in the presence of channel estimation errors is presented. The possibly correlated coefficients of the multiple-input multiple-output (MIMO) propagation channel are assumed to be affected by flat block fading and the transmitted symbols belong to a pulse amplitude modulation or quadrature amplitude modulation signal constellation. For both square and nonsquare OSTBCs, we derive approximate and exact BER expressions, irrespective of the distribution of the fading. It is also shown how the exact expressions can be efficiently and accurately evaluated using numerical integration techniques. Their application to the arbitrarily correlated Nakagami-m fading channel is presented and an efficient importance sampling technique is derived. As the high diversity order resulting from the application of OSTBCs gives rise to small BER values, the numerical evaluation of the presented BER expressions is much faster than straightforward Monte Carlo simulations. BER results have shown the impact of both imperfect channel estimation and antenna correlation on the performance of MIMO OSTBC systems. It is also shown that under highly correlated conditions, antenna correlation is the major source of BER degradation.