Pathological narcissism involves maladaptive efforts to regulate the self and is conceptualized by 2 key features: narcissistic grandiosity and narcissistic vulnerability. Prior research has found that narcissism is associated with poorer functioning over the long term, especially interpersonal functioning. Despite this, the specific contributions of grandiosity and vulnerability to different domains of functioning remain understudied. In particular, there has been scant literature investigating pathological narcissism and its effects on functioning in large clinical samples. Understanding how grandiosity and vulnerability each contributes to dysfunction will help inform the conceptualization, prognosis, and treatment recommendations, alike, for narcissism. This study examined the relations between narcissism and different domains of dysfunction in a sample of 288 current or recent psychiatric outpatients. Results suggest that narcissistic grandiosity is associated with specific deficits in interpersonal functioning, whereas vulnerability is associated with all forms of dysfunction. However, after accounting for the shared variance in the predictors, vulnerability continues to be predictive of all forms of dysfunction, whereas grandiosity serves as a modest protective factor. (PsycINFO Database Record (c) 2019 APA, all rights reserved).