A judge makes commitment determinations in Minnesota. The judge listens to evidence on both sides, which may include evidence of past sexual misconduct that did not result in an arrest or conviction. The state has the burden to prove that commitment is necessary, but its burden of proof is not as high as in a criminal case. If the judge finds by clear and convincing evidence that the individual is a sexual psychopathic personality or a sexually dangerous person, the person will be committed to a secure treatment facility operated by the Minnesota Sex Offender Program.

Officials generally have 60 to 90 days to evaluate the inmate and report back to the court once a person has been committed. The court then holds a second hearing to determine whether an indeterminate commitment is required.

Minnesota mainly relies on group therapy to treat civilly committed sex offenders. The offender progresses through three stages: the evaluation stage, the inpatient treatment stage and the transition stage. The inpatient treatment stage consists of four parts; an offender must pass each before progressing to the next stage. The parts are accountability, insight, integration/behavior change, and preparation for the transition stage.

A review board determines when discharge, transfer, or other change in status is appropriate. Requests for such a hearing may come from the patient, the patient's attorney, or the facility medical director. After a hearing, the review board recommends a course of action to the Commissioner of the Minnesota Department of Human Services. The Commissioner then issues an order denying or granting the petition. The Commissioner's order is subject to appeal, ultimately by the Minnesota Supreme Court.