Chief Magistrate Howard Riddle has ruled that Mr Dewani, who has depression and post-traumatic stress disorder, and strongly denies any involvement in his wife's murder, should return to the country with prosecutors successfully arguing that there had been a "significant and sustained improvement" in his mental health in recent months.
The 33-year-old (pictured in 2011) is accused of plotting and ordering the killing of his new wife, 28, who was shot as the couple travelled in a taxi on the outskirts of Cape Town.
"It is not impossible that if returned now, then after a reasonable period of further treatment and assessment he (Mr Dewani) will be found fit to plead and a trial can take place," Chief Magistrate Riddle said.
Mr Dewani's lawyers claim he is a high suicide risk and his human rights could be breached because of the risk of violent and sexual assaults in jail and of contracting HIV.
Last year, Xolile Mngeni was convicted of premeditated murder for shooting Mrs Dewani, while taxi driver Zola Tongo was jailed for 18 years after he admitted his part in the crime, and another accomplice, Mziwamadoda Qwabe, was handed a 25-year prison sentence.
Chief Magistrate Riddle ruled in 2011 that Mr Dewani should be sent back to South Africa but this was successfully appealed and he was ordered to look at the high profile case again.
Mr Dewani has 14 days to appeal the latest ruling.
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