Objective: The Rey Complex Figure Test (RCFT) is a complex neurocognitive measure frequently administered in pediatric neuropsychological practice. While hypothesized to assess perceptual, motor, and constructional skills as well as executive functions, no studies to date have investigated the neurocognitive predictors of RCFT performance within a children's psychiatric inpatient setting. Method: A medical chart review was conducted for 90 children aged 6–12 years with a mood, anxiety, or adjustment disorder who received a neuropsychological evaluation during a children's psychiatric inpatient program hospitalization from 2010-2014. A series of hierarchical regression analyses investigated the role of executive functions in the RCFT-Copy Condition performance when controlling for perceptual, motor, and constructional skills. Measures of perceptual reasoning, fine motor dexterity, and visual-construction were entered into block 1 for all analyses, followed by the executive domain of interest (i.e., cognitive flexibility, inhibitory control, and problem solving). Results: Results of analyses indicated that cognitive flexibility, notably Wisconsin Card Sorting Test-Perseverative Errors (p = .009), accounted for a significant proportion of additional unique variance in RCFT (24% of RCFT variance), over and above that accounted for by perceptual reasoning, fine motor dexterity, and visual-construction. Inhibitory control and problem solving did not account for a significant proportion of additional variance. Of those perceptual, motor, and construction variables, only perceptual reasoning provided an independent, significant proportion of variance. Conclusion: These results indicate that the RCFT contains inherent perceptual and executive demands. Evaluation of the child's RCFT performance within clinical practice should consider the influence of perceptual and executive functions to ensure proper RCFT interpretation.