Also unexplored are the potential differences between female insanity acquittees and their correctional counterparts, both subgroups of the mentally ill offender population. This study analyzed 30 years of insanity acquittals in Missouri, finding that females were more likely to have committed murder, more likely to have been diagnosed with major depression, more likely to be older, more likely to have been married, less likely to have a substance abuse diagnosis, and more likely to be diagnosed with borderline personality disorder than male counterparts. Differences emerged when female insanity acquittees were compared to the female correctional population. Race differences were also found within the female insanity acquittee population. The focal concerns perspective is discussed to interpret implications for future practice and research. Abstract published by arrangement with Taylor Francis.