This study aims to analyze the presence and extent of the ceiling effect in the TECO-D Physiotherapy test administered to students at Sapienza University of Rome. Identifying items affected by this phenomenon is essential to improving the test’s discriminatory power and reliability. A cross-sectional observational study was conducted with final-year Physiotherapy students at Sapienza University of Rome. Participants completed the TECO-D test, which consists of multiple-choice questions covering ten core competency areas. The test was administered digitally under controlled conditions. Statistical analyses included mean, standard deviation, median, and interquartile range calculations. The ceiling effect was considered present if more than 15% of students achieved the maximum possible score on an item or the overall test. The TECO-D Physiotherapy test was administered to 1,099 students. Several items exhibited a ceiling effect, particularly in the first competency area (Biology, Anatomy, and Physiology), where 12 items surpassed the 15% threshold. The overall ceiling effect for this area was 18.7%, indicating that a significant proportion of students had already mastered these competencies at the time of testing. The presence of a ceiling effect in specific test items suggests the need for revision to enhance the discriminatory capacity of the TECO-D in Physiotherapy. Refining test items will contribute to a more accurate assessment of students’ competencies, ultimately improving educational evaluation and training quality in physiotherapy education.