External examining is a system of quality assurance in nursing education that is quite foreign to most American nurses. The concept of an external examiner-a visiting assessor of high academic standing and possessed of integrity and objectivity-supports a notion of the universality of educational standards and justice for the individual student. Potential external examiners are appointed primarily through informal social and professional networks within educational institutions of the host country. Criteria for appointment, roles and functions of an examiner, and the four stages of the external examination process are discussed. Suggestions to facilitate each stage as well as implications for potential American external examiners are included. The manuscript concludes with insights from two American nurse educators about their experience as external examiners.