A multilevel approach was proposed for the assessment of differential item functioning and compared with the traditional logistic regression approach. Data from the Comprehensive Osteopathic Medical Licensing Examination for 2,300 freshman osteopathic medical students were analyzed. The multilevel approach used three-level hierarchical generalized linear models. The software HLM for Windows executed the hierarchical linear model (HLM) analysis and the Statistical Analysis System Proc Logistic was used for the conventional logistic regression analysis. It was not surprising to see that HLM was more conservative in identifying DIF in this study. The study demonstrates that the multilevel approach to DIF is meaningful and the results of its use appear reasonable. Implications for use of the two approaches are discussed. (SLD)