The creation of item response theory (IRT) and Rasch models, inexpensive accessibility to high speed desktop computers, and the growth of the Internet, has led to the creation and growth of computerized adaptive testing or CAT. This form of assessment is applicable for both high stakes tests such as certification or licensure exams, as well as health related quality of life surveys. This article discusses the historical background of CAT including its many advantages over conventional (typically paper and pencil) alternatives. The process of CAT is then described including descriptions of the specific differences of using CAT based upon 1-, 2- and 3-parameter IRT and various Rasch models. Numerous specific topics describing CAT in practice are described including: initial item selection, content balancing, test difficulty, test length and stopping rules. The article concludes with the author's reflections regarding the future of CAT.