He has opted to defend himself in the trial, although he has no legal background, and has said he needs more time to prepare.
He faces 11 counts of genocide and war crimes for masterminding Serb atrocities during the 1992-95 Bosnian war.
The bloodiest conflict seen in Europe since the Second World War left an estimated 100,000 people dead.
'Criminal intent'
Serge Brammertz, chief prosecutor in the case, has said he expects the trial to start as scheduled on Monday despite Karadzic's boycott.
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Al Jazeera's Tim Friend reports on Karadzic's decision to boycott the opening of his trial
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"We hope to be able to prove the criminal intent and to show that it was a planned operation - ethnic cleansing, genocide - planned in advance, implemented by Karadzic, Mladic and a number of other persons," Brammertz said.
"This trial is important for the victims who will finally see justice being done," he told the AFP news agency.
Karadzic has repeatedly refused to enter pleas, but insists he is innocent.
According to the charge sheet, he stands accused of having "participated in an overarching joint criminal enterprise to permanently remove Bosnian Muslim and
Bosnian Croat inhabitants from the territories of Bosnia Hercegovina claimed as Bosnian Serb territory."
His trial is expected to last for up to two years and he faces a maximum sentence of life in jail if convicted.
Arrested
The former Bosnian Serb leader was arrested in Belgrade last July after 13 years on the run.
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| Dozens of survivors of the Bosnia war plan to travel to The Hague for the trial [Reuters] |
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.
Charges
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 44-month siege of Sarajevo that left another 10,000 dead.
The opening of the trial is expected to start at 0900 local time on Monday (0800GMT), beginning with two days of opening statements by the prosecution to the court's three judge panel.
Karadzic will then be given the opportunity to present his opening statements in his defence a week later.