Mental State at the Time of the Offense (MSO) evaluations are used to inform the criminal courts in determinations of criminal responsibility and are an important part of psycholegal practice. Evaluator judgments of defendants' mental state at the time of the offense can significantly influence court determinations, yet research suggests these judgments are not standard across evaluators or jurisdictions and have poor interrater reliability. The current study utilized a mixed methods design to examine patterns of use and acceptability of various aspects of MSO evaluations. Several psychological tests were endorsed as ideal, but not frequently used in practice, while several clinical interview topics are utilized more in practice than recommended by participants. Results may aid legal decision making and inform research regarding MSO evaluation standardization.