Karadzic faces 11 counts of genocide, war crimes and crimes against humanity charges for his role in the 1992-95 Bosnian war, in which some 100,000 people died.
The former leader has repeatedly refused to enter pleas, but insists he is innocent.
Karadzic will have seven days to apply for permission to appeal the ruling, and another seven days thereafter to file an appeal.
Among the key charges Karadzic faces is one count of genocide over the massacre of Muslim men and boys at the UN-protected enclave of Srebrenica in July 1995, in which about 8,000 people died.
He also faces another genocide charge over the siege of Sarajevo.
His trial is expected to last for up to two years and he faces a maximum sentence of life in jail if convicted.
Karadzic was arrested in Belgrade last July after 13 years on the run.
He had been posing as New Age healer, named Dr Dragan Dabic, and had disguised behind thick glasses, a bushy beard and straggly gray hair.
Prosecutors had wanted to try Karadzic alongside his wartime military chief, General Ratko Mladic, but Mladic has yet to be apprehended - one of two suspects still sought by the court.
The other is Goran Hadzic, a former leader of rebel Serbs in Croatia.