In this study, we developed the Rorschach Alexithymia Scale (RAS) to be used with protocols scored with the Comprehensive System (CS; Exner, 1993). A total of 92 patients with medical disease and 127 psychiatric outpatients were administered the Rorschach and the 20-item Toronto Alexithymia Scale (Bagby, Parker, & Taylor, 1994a, 1994b). We used a systematic approach, including cross-validation, to reduce a pool of 27 CS codes issued from an earlier investigation (Porcelli & Meyer, 2002) to 3 variables: Form%, CDI, and Pop. The RAS showed excellent diagnostic accuracy (hit rate of 92%, sensitivity of 88%, specificity of 94%, and area under the curve of .96). We suggest that the RAS can be used as a reliable integrative tool in a multimethod assessment approach to measuring alexithymia.