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Kernberg’s (1984) conceptualization of malignant narcissism describes individuals whose pathological grandiosity has been infiltrated by high levels of aggression and includes associated clinical characteristics such as paranoia, psychopathy, and sadism. While a theoretically rich construct, there has been limited empirical assessment of malignant narcissism to date, yet it may provide one way to understand the heterogeneity and treatment complexity of patients with borderline personality disorder (BPD). The present study developed an index for assessing malignant narcissism using trait-based, dimensional measures of pathological narcissism and psychopathy and examined the nomological network associated with malignant narcissism in a sample of 60 patients diagnosed with BPD. Results showed that our malignant narcissism index was related to Diagnostic and Statistical Manual of Mental Disorders (DSM) conceptualizations of BPD and narcissistic personality disorder, but not antisocial personality disorder. Our index was also related to symptoms of paranoia and psychoticism, as well as trait anger, social potency, negative emotionality, and positive emotionality. We discuss the implications of our results for assessing malignant narcissism in those diagnosed with BPD.