A competency-based learning (CBL) environment focuses on the performance of learners in essential professional tasks encompassing clinical skills such as decision-making, technical skills, and communication. Unlike traditional educational models that emphasize time and volume of experiences, CBL prioritizes achieving specific performance standards, thereby granting autonomy to learners once they meet these benchmarks. This shift is crucial for maintaining care standards and public trust in the medical profession. Assessments within CBL are framed around formative and summative practices; formative assessments provide feedback to guide learning, while summative assessments evaluate a trainee’s skill level at specific points during training. These systems also allow the implementation of precision education, which enhances personalized learning trajectories by analyzing multiple data sources to deliver tailored feedback. This chapter outlines practical strategies for developing an effective CBL assessment system in general surgery training, integrating various assessment tools to create a comprehensive view of trainee capabilities. Additionally, it leverages George Miller’s pyramid of learning to contextualize assessment at differing levels of competency, emphasizing the necessity of diverse evaluation methods. Ultimately, a robust CBL approach fosters an environment of continuous learning and improvement, ensuring trainees are well-prepared for independent clinical practice.