The aim of this report is to examine the treatment of Medical Foundation Medico-Legal Reports (MLRs) by Immigration Judges in the Tribunal (Asylum and Immigration Chambers) and to assess compliance with good practice standards and guidelines. The determinations assessed in this sample demonstrate that many Immigration Judges are familiar with and apply the guidance that is given, primarily in case law, on the treatment of expert medical evidence for cases involving a claim of torture, as well as the standards articulated in the Istanbul Protocol. However, the evidence shows that there is a serious lack of consistency in the treatment of MLRs across the Tribunal and that in a significant number of cases the guidelines given in case law and good practice standards are not followed by Immigration Judges, leading to a dismissal of the appeal.The findings of this research have very serious resource and efficiency implications for the UK Border Agency and the Tribunal to consider, since poor decision making leads to an unnecessarily protracted legal process.Torture survivors should be able to focus on their rehabilitation, not on unnecessary legal proceedings.