The UK National Health Service (NHS) is currently under increasing pressure due to financial and recruitment problems, as well as our increasing aging population.Nursing has continued to adapt its role to meet the needs of these challenging times.Over the last few years the Advanced Nurse Practitioner (ANP) role has been implemented widely in both primary and secondary care. However these roles have lacked consistency in scope of practice, training and regulation. This paper summarises the development of the ANP role in the UK and internationally, and current issues around regulation. Globally ANPs are regulated by one of three different mechanisms, nationally by central government or a professional body, or locally by employers. In the UK the role is regulated by local procedures, relying on employers to make decisions about the scope and preparation for practice. Some of the challenges of the UK position in relation to ANP regulation will be discussed, including variations in scope, organisational constraints, and lack of support. It has been suggested that these challenges are exacerbated by a lack of role clarity, therefore highlighting a need to improve regulation of ANPs. The RCN has moved some way to responding to these challenges by introducing 'credentialing'; a system for recording qualifications, skills and experience, but the uptake of this is yet to be evaluated. This review highlights that employers and ANPs need to be aware of their collective responsibility for ensuring appropriate role regulation.