The authors provide an overview of issues germane to mental health professionals who are involved in the release decision-making process for offenders with special needs. The authors briefly discuss some of the history and limitations of prediction and release decision making. Then the authors provide an overview of strategies and methods to improve mental health professionals' decision making for offenders with special needs. Included in this discussion is a review of factors that clinicians must be aware of when making release decisions, including relevant base rates of recidivism for offender populations of interest and various risk factors (both individual and environmental—contextual) that either increase or decrease the probability of reoffending among offenders with special needs. Following this discussion of risk factors is a review of several instruments that may be used in release decision making and release planning contexts. Next the authors address how clinicians should structure their release recommendations and how this information should be conveyed to relevant authorities. Finally, the authors conclude with recommendations for future research.