The Origins Space Telescope (Origins) traces our cosmic history, from the formation of the first galaxies and the rise of metals to the development of habitable worlds and present-day life. Origins does this through exquisite sensitivity to infrared radiation from ions, atoms, molecules, dust, water vapor and ice, and observations of extra-solar planetary atmospheres, protoplanetary disks, and large-area extragalactic fields. Origins operates in the wavelength range 2.8 to 588 microns and is 1000 times more sensitive than its predecessors due to its large, cold (4.5 K) telescope and advanced instruments. Origins was one of four large missions studied by the community with support from NASA and industry in preparation for the 2020 Decadal Survey in Astrophysics. This is the final study report.