This is the first detailed study of patients admitted to a Scottish pauper asylum. A one in four sample of patients admitted to the Fife and Kinross District Asylum between 1874 and 1899 was undertaken and yielded 262 males and 266 females. Each patient's case-notes were studied from admission to the time of discharge and a wide range of information relating to sociodemographic and clinical features was extracted and subsequently analysed. The study found that while the Fife and Kinross Asylum shared many of the features of its English counterparts, the general picture was less bleak: the Asylum population did not grow to such large numbers; the recovery rate did not fall so precipitately and even rose towards the end of the century and cases of general paralysis were less frequent. In the discussion, these findings are related to other asylum studies.