The effect of medium secure care on reoffending is unknown; adequate control groups cannot be identified and exposure to reconviction may be confounded by onward placement and by legal restrictions. Retrospective analysis of convictions for an England and Wales National Cohort of adults discharged from 35 medium secure services during 1997/8. Data were retrieved from the Offenders Index and from each service. Reconviction risk for 711 cases was estimated using Offending Groups Reconviction Scale-2 (OGRS-2). Reconviction (any standard list offense) served as the sole outcome during a uniform six-year follow up. Reconviction outcomes were highest following transfer to prison, reduced by further secure care whilst restriction orders were effective in reducing convictions only in those at high risk. Substantial reductions in reconvictions were observed across the full range of criminogenic risk after control of the above confounding. OGRS-2 proved a useful assay for estimating the effects of secure services on reconvictions. Analysis of more contemporary samples using the current methods and more recent versions of OGRS is warranted.