To enter practice as an occupational therapist, one must complete an occupational therapy program at an accredited institution and then pass a national certification exam. This exam is called the National Board for Certification in Occupational Therapy (NBCOT) Exam. Individuals can take the exam more than once to achieve a passing score but must pay a fee each time. Not passing the first time can lead to stress, increased costs, and delayed entrance into the profession. Thus, being a first-time passer is ideal. The purpose of this retrospective quantitative study was to identify variables impacting first time pass rates of occupational therapy master's students. Variables found to be significantly higher in the first time pass group compared to the multiple attempts group include high school grade point average (hsGPA), Scholastic Aptitude Test (SAT) scores, whether or not the student earned an A in high school chemistry or biology, whether or not the student took high school physics, undergraduate college GPA, whether or not the student earned an A in certain occupational therapy intervention courses, and percentage correct on the Occupational Therapy Knowledge Exam (OTKE). Results of this study can inform occupational therapy programs' admissions standards and help educators better prepare and support students throughout the entire curriculum to facilitate first time success on the NBCOT exam.