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Personality disorders are characterised by persistent functional difficulties affecting self-perception and interpersonal relationships, manifesting across domains such as affect, identity, and relational dynamics. The aetiology is complex, involving both environmental and biological factors, with early developmental experiences playing a crucial role. Prevalence rates vary, with significant representation in forensic settings, where cultural and gender considerations further complicate diagnosis and treatment. Comorbidity with other psychiatric conditions is common, complicating clinical presentations and delaying diagnosis. Dimensional diagnostic models are increasingly favoured over categorical ones, improving diagnostic accuracy. Effective treatment often involves psychotherapy, with interventions tailored to individual needs and settings. The therapeutic alliance and common factors significantly influence treatment outcomes, highlighting the importance of relational frameworks in therapy. Stigma remains a significant barrier, affecting both diagnosis and treatment. Supervision and reflective practice are essential for maintaining clinician well-being and improving therapeutic efficacy. Understanding these complexities is vital for effective management and treatment of personality disorders, particularly in forensic contexts.