Objectives: To evaluate multiple-choice questions of the Medical Licensing Examination. Methods: The study design was a cross sectional descriptive and item analysis method was used. This study was conducted in Health Development Center of the Ministry of Health. An item analysis was done on 1500 multiple-choice questions for the internal medicine licensing exam and of 2077 subjects from 2014 to 2016. The item analysis involved identifying reliability coefficient, difficulty index, and discrimination index for each question in relation to the doctors' exam performance. Microsoft Excel 2010, and SPSS were used for the statistical analyses. Results: Reliability coefficient (KR20) of Mongolia's medical licensing examination in 2014-2016 ranged from 0.79-0.92. The frequency of multiple-choice questions with a negative or zero discrimination index was 11.6 percent and a high difficultly index was 21.9 percent. Conclusion: Even though reliability of Mongolia's medical licensing examinations were good, one-third of the multiple-choice questions used in the exams fail to evaluate examinee's knowledge.