Cognition is often discussed as being of fundamental importance to an accused person's fitness to stand trial (FST); however, there is limited empirical research in this area and no known published research within Australia. The aim of the present paper was to investigate the current practices of experts conducting FST assessments in Australia and to examine the role of cognition in these determinations. Expert reports (328) for 135 accused deemed unfit to stand trial between 2005 and 2010 in New South Wales (NSW) were examined. Collected data included the cognitive domains assessed, assessment techniques employed, the relationship between cognition and the Presser criteria, and demographic information. Results supported the hypothesis that cognition plays an important role in FST, in particular attention and memory; although there was significant variability in the practices and assessment methods of assessors. Results indicate a need for further research investigating the relationship between cognition and FST; as well as training and education for psychologists conducting FST assessments in Australia.