Ressler reviewed the PTSD claim on behalf of the prosecution before the trial. From the time Shawcross returned from his tour of duty, he told acquaintances of seeing American soldiers 'skinned from their neck to their ankles', and claimed to have decapitated two women he had victimized, 'placing' their heads on poles. Shawcross, who had served in Vietnam with the 4th Supply and Transport Company of the 4th Infantry Division, had told many outlandish tales of murderous activities (including cannibalism), often perpetrated while alone in the jungle. Shawcross pleaded not guilty by reason of insanity, with testimony from psychiatrist Dorothy Lewis that he had brain damage, multiple personality disorder (now known as dissociative identity disorder) and post-traumatic stress disorder, and had been sexually abused as a child. Siragusa for the 10 murders in Monroe County. In November 1990, Shawcross was tried by Monroe County First Assistant District Attorney Charles J. He was convicted of 11 murders, with a 12th not officially charged to him. In March 1988, Shawcross began murdering again, primarily sex workers in the area (apart from June Stott, who was a local and was the first one of his victims to be mutilated after her death), before his capture less than two years later. In November, he was transferred from Attica to Green Haven Correctional Facility. McClusky also suggested Shawcross could have argued at trial that he was under 'extreme emotional disturbance', and a jury would have been likely to arrive at a verdict of manslaughter. Jefferson County District Attorney William McClusky explained the plea by stating there was no direct evidence linking Blake and Shawcross, only Shawcross' confession to police. A grand jury indicted Shawcross for murder in Hill's death, but on October 17, he was allowed to plead guilty to a lesser charge of first degree manslaughter for both deaths and was sentenced to an indeterminate term at Attica, with a maximum of 25 years. On September 2, Just prior to the body's discovery, he raped and killed eight-year-old Karen Ann Hill, who had been visiting Watertown with her mother for the Labor Day weekend. The body wasn't found until authorities received a tip by phone on September 5.

On May 7, 1972, he raped and killed 10-year-old Jack Owen Blake, his first known victim, after luring the boy into some woods in Watertown. Shawcross returned to Watertown, eventually getting a job with the Watertown Public Works Department, and marrying for the third time.

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