Archival data of inpatient defendants referred for competency restoration were used to make comparisons between those who were restored to competency (CST; n = 43) and those who remained incompetent (IST; n = 15). The groups did not differ on demographic variables, intellectual capacity, type of offense (violent versus nonviolent), clinical diagnoses, substance abuse, or psychotic symptomatology, as measured by the Brief Psychiatric Rating Scale. However, the CST group performed significantly better than the IST group on both the initial and final Georgia Court Competency Test and Global Assessment of Functioning scale. Psychotic symptom severity decreased significantly only in the CST group, and the CST group was discharged significantly sooner (7.7 ± 8.6 months) than the IST group (17.9 ± 7.0 months). While consistent with prior research, this is the first study to compare both psycholegal comprehension and specific clinical symptoms in defendants before and after competency restoration treatment.