The professional literature almost uniformly affirms the low accuracy of predictions of dangerousness of mental patients. Thus, legal attacks on the assumption of psychiatric expertise in prediction will probably increase unless better predictive accuracy can be scientifically demonstrated. Possible ways to increase predictive accuracy are to shorten or to specify the time frame of predictions, to specify social and environmental factors associated with aggression, to incorporate statistical prediction techniques into clinical decisionmaking, and to use the two-dimensional system used by the United States Board of Parole. Possible treatment approaches include desensitization techniques, conditional release, and treating patients while they are moderately intoxicated with alcohol to deal with behaviors that occur during intoxication. Much more research is needed to develop effective treatment interventions, however, 73 references.