Background. The Danish Medico-Legal Council provides the court with statements based on available psychiatric assessment reports to assist the law in the use of the Penal Code sections on mentally disordered offenders. Aims. To analyse the impact of the Council on the courts’ choice between punishment and treatment in cases of offenders falling under §69 of the Penal Code, i.e. mentally disordered, although not psychotic offenders. Methods. In 298 cases of defendants who according to the Medico-Legal Council might fall under §69 the recommendations of the assessment reports, the recommendations of the Council and the final verdicts are compared; and assessment reports from forensic psychiatric centres are compared with those from other psychiatrists. Results. The recommendations of the Medico-Legal Council were often, but not blindly followed by the courts. The probability for the Council to recommend some measure of treatment was about 50% for adult males, and higher for adolescents and for females. In court, however, the two genders as well as adolescents and adults alike all had the same probability, approximately 50%, of being sentenced with treatment instead of punishment. When measured by the final verdict, the Medico-Legal Council is of higher quality than the assessment reports, especially those from outside forensic psychiatry. Conclusion. The Council serves as a quality assurance of Danish forensic psychiatric assessments, and the Council's statements are by the court considered to represent the state of the art of these assessments.