Thirty‐five patients who had received at least one year's treatment in a learning‐disability medium secure unit were followed up for a maximum of five years. A good treatment outcome was more common in those with significant learning disability. At the end of follow‐up, 21 subjects (60%) were living in the community with support. The early months after discharge were a peak period for relapse. A very low level of reconviction was found, affecting only one subject. Patients who were older on discharge were less likely to re‐offend. The two deaths that occurred during follow‐up, and the three patients who required special (high security) hospital referral, are reported in detail. The findings are contrasted with the only comparable study (Day, 1988).