We examined the utility of the Psychosomatic Symptom Checklist in an inpatient medical setting with particular emphasis on the putative ability of the PSC to discriminate psychosomatic from nonpsychosomatic patients. First, 80 hospitalized psychosomatic patients were compared to 80 hospitalized medical patients on the PSC. Second, a sample of 187 psychosomatic patients was studied to examine the relationship among psychosomatic distress, depression, and functional impairment. The results indicate that while psychosomatic patients scored significantly higher than comparable medical patients on the PSC, discriminant analyses indicate that the PSC is not able to identify psychosomatic patients in an inpatient medical setting. Factor analyses and correlations show that the PSC is positively related to increased depression and decreased functional status. Results are interpreted in light of current psychosomatic theory.