This AMEE Guide offers an overview of methods used in determining passing scores for performance-based assessments. A consideration of various assessment purposes will provide context for discussion of standard setting methods, followed by a description of different types of standards that are typically set in health professions education. A step-by-step guide to the standard setting process will be presented. The Guide includes detailed explanations and examples of standard setting methods, and each section presents examples of research done using the method with performance-based assessments in health professions education. It is intended for use by those who are responsible for determining passing scores on tests and need a resource explaining methods for setting passing scores. The Guide contains a discussion of reasons for assessment, defines standards, and presents standard setting methods that have been researched with performance-based tests. The first section of the Guide addresses types of standards that are set. The next section provides guidance on preparing for a standard setting study. The following sections include conducting the meeting, selecting a method, implementing the passing score, and maintaining the standard. The Guide will support efforts to determine passing scores that are based on research, matched to the assessment purpose, and reproducible.