The significance of mental illness as a risk factor for violence has been contested, with substantial consequences for clinical treatment and mental health policy. Although this relationship has lately been called into doubt in relation to sexual offenders, mental health diagnoses often have no effect on recidivism in offender samples. In the current, prospective analysis, the significance of various mental health diagnoses and pertinent co-morbidity is evaluated as predictors of various types of recidivism in two different samples of sexual offenders who were followed up to 27 years in the community. According to the findings, neither on their own nor in multivariate categories did mental health diagnoses predict recidivism, albeit comorbid drug use disorders and a few personality disorders did exhibit some construct power.