The subject of spiritual assessment in healthcare practice raises many conceptual, practical, organisational, and ethical challenges. These challenges undoubtedly influence the nature and way spiritual assessment is perceived, approached, and undertaken. It also raises several questions about quality and governance and providing evidence for this aspect of care. Therefore, this chapter will explore what is meant by the idiom ‘spiritual assessment’. The chapter will briefly introduce readers to the main classification of assessment tools currently documented in healthcare literature. It will also describe and discuss some of the factors and features influencing the implementation and success of spiritual assessment tools used within diverse healthcare contexts.