Background: Delusional disorder presents with a stable and well-defined delusional system. Many are unwilling to accept that they have a mental disorder or that they require psychiatric treatment. The condition responds to treatment in most cases. This study aims to assess the clinical profile, treatment pattern and response to it, frequency of follow-up and current status of patients previously diagnosed as delusional disorder. Method: The case records of all patients who had come to Psychiatry OPD for 3 years with a diagnosis of delusional disorder according to ICD-10 criteria were taken and data collected. 48 patients were enrolled in the study. The current status was assessed from relatives through telephone calls. Results: The sample consisted more of males; the majority were married. The most common delusion was infidelity (72.9%) followed by persecution (22.9%). Co-morbidity was present in 43.8% of subjects. The best response was with risperidone. At follow up, all were reported to be doing a job or engaging in household work and the majority maintaining improvement. Eight had delusions and six were troublesome. Less than half of the responders were continuing their treatment. Conclusion: Male preponderance and married status were noticeable. The delusion of infidelity was the most common. The delusional disorder has much co-morbidity. Non-compliance with treatment is common. But the level of functioning is found to be reasonably fair irrespective of the treatment status.