Reliable and valid methods to evaluate student competence are needed in social work education, and practice examinations with standardized clients may hold promise for social work. The authors conducted a critical appraisal of standardized client simulations used in social work education to assess their effectiveness for teaching and for evaluating social work students' competence. Following a comprehensive search, 18 studies, including 515 social work students, were examined. The authors extracted data from these studies and study methods and assessed the results. This review found that studies vary in methodological quality; however, using standardized client simulations is well-received by students. Consistent implementation methods and reliable, valid assessment measures are needed to advance this evaluation method for social work. (Contains 1 table.)