It is common, accepted clinical practice to conduct risk assessments of individuals who commit sexual offenses using the combination of sexual violence risk actuarial measures and dynamic risk factors. This assessment approach has utility when identifying treatment targets, assessing progress in sexual offender treatment, and forming risk management plans. Little research has examined this method in forensic contexts such as deciding whether individuals who suffer from mental disorders are likely to engage in sexually dangerous behavior as defined by sexually violent predator or persons (“SVP”) involuntary civil confinement laws in the USA. In particular, it is uncertain whether the combination of sexual violence risk actuarial measures and dynamic risk factors (DRF) produces sufficiently reliable, relevant, and probative evidence for the trier of fact to properly evaluate the SVP legally defined likelihood of sexual dangerousness. This article explores the efficacy of combining actuarial measures of sexual violence risk and dynamic risk factors as applied in SVP risk assessments based on some commonly observed forensic practices among evaluators. Based on the analysis, recommendations for forensic practice and future research are offered.