State-specific credentialing of school nurses is generally equivalent to state teacher certification and is regulated by state departments of education. This certification establishes statewide employment standards for school nurses, as opposed to competency-based professional certification. Although more than half of all states currently have some type of credentialing for school nurses, it takes many different forms. The advantages of certification are pronounced but are surpassed by the barriers to its establishment. Considerations in establishing certification are presented along with analysis of the various forms of certification that exist in states that have school nurse certification.