Personality disorder is a contentious diagnostic label that is associated with high levels of stigma, leading many practitioners and people with lived experience to call for a change in its use. Mental health nurses frequently encounter people who have received a diagnosis of personality disorder in various settings. This article provides a critique of this diagnosis and discusses the issues that are associated with this label. It explores alternative conceptualisations of personality disorder and emphasises the importance of formulation as a tool for making sense of service users’ past experiences. The article also details evidence-based interventions, trauma-informed care and interpersonal approaches that may be beneficial when working with this client group.