He'd been hiding in plain sight as a health guru, of all things, complete with young girlfriend, fake family, and strange hair.
The bizarre preposterousness of it would be funny if it weren't for the fact that he is accused of masterminding the murder of more than 100,000 people, of leaving approximately 2 million people homeless during the war in Bosnia.
It began in 1992, with the siege of Sarajevo … the massacre at Srebrenica, where Bosnian Serb troops rounded up eight thousand Muslim men and boys and shot them … the prison camps …
CBS News correspondent Martha Teichner was there in the summer of 1992 when the Bosnian Serbs introduced the world to the term "ethnic cleansing," their ugly euphemism for purging a place of an ethnic minority by any means.
To our cameras, the emaciated appearance of the prisoners was the guards' biggest concern. "Don't just photograph the skinny ones," they warned us, forcing the prisoners to put their shirts back on.
In Bosnia that summer, I first met Richard Holbrooke, who eventually negotiated the Dayton peace accords, ending the war in December 1995.
"I did not shake their hands," he told Teichner. "Some of my colleagues did, others did not."
Holbrooke recalls a negotiating session with the men the International War Crimes Tribunal named above all others as responsible for the Bosnian War: the late Serbian president Slobodan Milosevic, General Ratko Mladic, and Karadzic.
"I'd never met anyone in my life who I thought was more evil, more awful, than Radovan Karadzic," Holbrooke said.
He considers him the worst of what he calls "the evil three."
"Milosevic was a political opportunist who bankrolled the war," he said. "General Mladic was the mass murderer, the hands-on murderer of Srebrenica. Karadzic was the intellectual architect of what was called ethnic cleansing. He was a well-known if lousy poet, and he was a psychiatrist with a New York City education, which is a lot of prestige - but underneath all that, he was a crazed racist."
Denial has always been his defense, evident in a 1995 60 Minutes interview with Mike Wallace.
"I'll tell you, my army or my police have never committed any, any rape or any crime or atrocities," Karadzic said.
"Your people up there did not herd men into, and women and children, into soccer fields and then take off the women and the children in buses and trucks and then march the others off to be shot?" Wallace asked.
"No, I don't believe that something like that happened," Karadzic replied.
"No mass graves?" Wallace asked.
He'll have to explain this … once he comes to trial.
Many Serbs consider Radovan Karadzic a hero. In the Serbian capital Belgrade this past week, there were riots when his arrest was announced.
But in Sarajevo, on the receiving end of so much horror, there were celebrations.
Karadzic may be extradited this week to the Hague, the Dutch city where the International Criminal Tribunal for the Former Yugoslavia is located.
Holbrooke said the importance of Karadzic going to the Hague is that "it proves the value of the war crimes tribunal process, it proves that you can run but can't hide."
Of Holbrooke's "evil three," Slobodan Milosevic died in 2006 while on trial for war crimes. Karadzic is now in custody, but General Ratko Mladic is still at large.
In Muslim Srebrenica was where witnesses report that Mladic told people gathered, in what was supposed to be a U.N. safe haven, that no one would be harmed … shortly before ordering the killing to begin.
For the mothers and wives and sisters left behind, for the orphans and displaced families of Bosnia, what happens in a Dutch courtroom can't undo death, can't erase the fact of genocide. But if not justice exactly, it's the world's best attempt … and a warning to war criminals that in time, they will be made to pay.