This article reviews the recent development of juvenile competency to stand trial (CST) policies across the United States in light of the inherent contradiction of this due process procedure in a separate juvenile court that is premised on the incompetence of youth. The article draws on existing CST legal doctrine and psycho-legal research to demonstrate the need for sociolegal research to better understand who gains access to the CST process, CST decisions, and how CST may influence subsequent case processing decisions. Utilizing CST as an adopted formal policy from criminal court and an exploratory case study, I demonstrate the difficulties facing how court actors manage the role of youthfulness and culpability for CST decision-making in contemporary juvenile courts. Overall, both quantitative and qualitative research is needed to examine whether court actors’ practice of CST serves to further deconstruct or reinforce the juvenile court’s rehabilitative ideal.