In educational measurement, test scores are widely used in deciding student selection in college admission, evaluating students’ understanding of a topic, determining the appropriate level of students and determining if the student has achieved the required performance level to graduate in the program. In the high-stakes examinations for dental programs, the standard setting marks the “right” level of knowledge and skills necessary in fostering trust and accountability among the stakeholders and public, affirming the graduate’s competence to practice. Standard setting methods used in setting the performance standard vary depending on the specific objectives and stakes of the evaluation. There are several ways to classify standard setting methods. This chapter discusses the different standard setting methods based on norm-referenced and criterion-referenced approaches. This chapter also discusses different standards and addresses key considerations, providing examples of calculations, advantages, and disadvantages associated with each standard setting method. The roles of the facilitator, subject matter experts, and policymakers are outlined to explain their contributions in standard setting process. It is noteworthy that criterion-referenced standard setting methods are typically applied in dental education examinations, occasionally combined with empirical data in the statistical measurement. The passing scores generated from the standard setting process ensure that graduating candidates have achieved the minimum level of competency based on the established criteria, safeguarding public safety while allowing competent candidates to enter and maintain the workforce within hospital settings. Establishing a credible, defensible, and acceptable passing mark within the constraints of resources in high-stakes healthcare education examinations presents a significant challenge. Hence, it is important to select the most defensible standard setting method and validate its outcomes.