A retrospective study was to conducted on all (n=700) patients who attended a community psychiatric clinic during the period 1995-1997 to assess the mental health morbidity in the Central District of Karachi. A comprehensive proforma was developed to ascertain the psychiatric diagnosis, relevant management and prognosis along with brief demographic profile. The various results were: depression 51.6%, anxiety neurosis 5.6%, schizophrenia 6.9%, substance abuse 1.6%, seizure disorder 16.0%, behavioural disorder 3.7%, personality disorder 0.6%, psychosomatic disorder 9.1%, mania/hypomania 0.7%, sexual disorder 1.9%, mental retardation 0.3% and dementia 2.1% Antidepressant prescription outnumbered other types of therapies. On follow up, 46% of the patients did not show improvement, 30% showed marked improvement whereas remaining 24% presented mixed picture. It was concluded that there is high mental health morbidity in Karachi's central district which is the largest part of the city, a fact which also implies the high prevalence of mental disorder in Karachi. There is a need to replicate this type of study on national level in order to become aware of the magnitude of mental disorders which could go a long way in designing an appropriate and effective mental health policy.