Following the Joint Commission on Accreditation of Hospital's emphasis on clinical privileging for professionals other than physicians, Saint Elizabeths Hospital implemented a criteria-based system for granting privileges to nurses. Current literature does not provide much, if any, guidance for the nursing administrator facing the task of developing such a system. This article describes the development and implementation of a successful system, as well as results of evaluation of the system 18 months after implementation, and recommendations for change.