Abstract: DSM-5 was published in May 2013, and ICD 11 is not due to be published until the end of 2015 at the earliest. Nevertheless, it is possible to make a comparison at this early stage as much of the main decisions have been made with both classifications. DSM-5 aimed to make a paradigm shift by providing objective, independent measures of classification, but in this respect it clearly failed. It did respond to previous criticisms that there were too many diagnoses in the classification and that eliminated some conditions in favour of larger groupings (eg, autism spectrum disorder), but it has still come in for heavy criticism. ICD 11 deviates from DSM-5 in radically different classifications of personality and stress disorders and in general has pursued a different pathway, concentrating on clinical utility as the main guide to the classification. It is up to practitioners to choose which they prefer, but ICD 11 will be in a much stronger position than ICD 10 was when it was published in 1992.