Licensure testing programs in the United States (e.g., nursing) face an increasing challenge of measuring the competency of internationally trained candidates, both in relation to their clinical competence and their English language competence. To assist with the latter, professional licensing bodies often adopt well-established and widely available international English language proficiency measures. In this context, the National Council of State Boards of Nursing (NCSBN) sought to develop a nursing-specific passing standard on the International English Language Testing System that U.S. jurisdictions could consider in their licensure decisions for internationally trained candidates. Findings from a standard setting exercise were considered by NCSBN's Examination Committee in conjunction with other relevant information to produce a legally defensible passing standard on the test. This article reports in detail on the standard setting exercise conducted as part of this policy-making process; it describes the techniques adopted, the procedures followed, and the outcomes obtained. The study is contextualized within the current literature on standard setting. The latter part of the article describes the nature of the policy-making process to which the study contributed and discusses some of the implications of including a language literacy test as part of a licensure testing program. (Contains 5 footnotes and 9 tables.)