The aim of this article was to compare the characteristics and outcome of homicide and non-homicide mentally disordered patients all of whom had been hospitalised. Seventy-four patients with a homicide conviction were compared with 521 convicted of a non-homicide offense. The former group were older, were more likely to be diagnosed with schizophrenia but less likely to have suffered from childhood adversity, and had less criminality. They also had fewer convictions during the follow-up. Little distinguished these two groups with both suffering from multiple disadvantages suggesting the need for ongoing care and support.