The shift toward competency-based education (CBE), outcome-based education (OBE), and the integration of competency-based assessment (CBA) frameworks in dental education is a response to the limitations of traditional time-based training models. CBE and CBA are critical in ensuring that dental graduates acquire the crucial knowledge, skills, and professional behaviors and attitudes necessary for safe and effective patient care delivery. This chapter provides a comprehensive overview of the cognitive, affective, and psychomotor domains of dental competencies, situating them within the CBE and OBE paradigms. Each domain is explained at length, with discussion of relevant assessment methods for reliable and valid evaluation of student performance. The emergence of other assessment approaches, such as programmatic assessment, EPA-based assessment, and interprofessional competence assessment, is also given due attention. The chapter also addresses key issues and emerging technology innovations in both preclinical and clinical assessment, highlighting strategies to enhance competency development, standardization, and the alignment of educational outcomes with the demands of contemporary dental practice.