While much is written about the regulation of healthcare support workers (HCSWs), many authors and policy makers do not distinguish between assumption and evidence. As calls for compulsory regulation of HCSWs grow louder, it is crucial that the evidence underpinning the debate on both sides is considered carefully and critically. The authors reviewed journal articles and policy documents with the specific aim of clarifying the arguments for and against further regulation from an evidence-based perspective. The majority of material recommended HCSW regulation, however, the mechanisms by which regulation would deliver better patient care were often missing and were rarely evidence-based. This article provides clear definitions of the key terms and processes needed to engage in the debate, followed by a summary of the arguments for and against the regulation of support workers.