Acute-care nurse practitioners must be knowledgeable of the mechanisms whereby their scope of practice is defined and regulated, and through which professional competence is ensured. The mechanisms whereby hospitals determine scope and practice parameters is through credentialing and the delineation of clinical privileges. This article supplies background for the influences to the credentialing and privileging process and provides insight into how the process is conducted. The potential future trend of economic credentialing is discussed briefly. Acute-care nurse practitioners are encouraged to negotiate for delineation of clinical privileges that are consistent with their professional and legal scope of practice, educational and individual capabilities, and the safe delivery of quality patient care. It is important that the process not be misused to erect barriers to practice, resulting in underserving of patient and organizational needs.