Mental health professionals are routinely called upon to assess and testify concerning the violence risk of their patients. Expert opinion on risk assessment continues to influence decisions resulting in the long-term denial of civil liberty or even death in the case of capital proceedings. Today, many clinicians use structured risk assessment tools to assist in these tasks. Although few would claim that violence can be predicted without error, all but the most skeptical would concede that our knowledge and ability to assess violence risk far exceeds that of three decades ago. This said, whether current practices are empirically, ethically, or legally valid remains a question of great importance given the consequences that may follow erroneous assessments. And while 30 years ago there was a broad (albeit often overstated) consensus that expert opinion on this topic was inherently suspect, today the field appears to operate on a broad (albeit often overstated) consensus that practices have improved to a sufficient extent to warrant the sizeable impact that violence risk assessments often have on individual liberty, levels of service, and resource allocation. Copyright © 2013 John Wiley & Sons, Ltd.