The Psychiatric University Hospital Zurich, formerly known as Burghölzli, is recognized as a European pioneer of eugenically motivated forced sterilizations. However, the role of outpatient psychiatry in Zurich's sterilization practices has previously been unclear. This study fills that research gap and also examines sterilization records from the psychiatric outpatient clinic. It places the sterilization practices within the context of birth control and population policy, analyzing patterns of action as well as the significance of eugenics, coercion, and gender. This results in a nuanced picture of Zurich's sterilization practices from the late 19th century to 1970. By including the records from the psychiatric outpatient clinic, the study concludes that from the interwar period onward, it was primarily local abortion policies—not eugenic considerations—that shaped the broad sterilization practices in Zurich.