Background: Building a portfolio is an appropriate method for assessing competency and practice in clinical settings. Portfolio assessment provides opportunities for students to reflect on their performance and therefore could have a critical role in observing students' progress and developing competencies. With the emphasis of modern medical education on e-portfolios, the present study was done to design, implement, and evaluate an electronic portfolio to assess surgical technologist students learning in Iran.Methods: This mixed study was conducted in three stages: "designing," "implementation," and "evaluation." The "design" stage included a literature review, the completion and modification of the list of portfolio items, and content approval by experts. The "implementation" stage involved loading the system, holding workshops for students and clinical preceptors. Finally, the "evaluation" stage included assessing preceptors' and students' satisfaction, knowledge, and clinical skills and recording the number of reflections. Results: The paired sample t-test result shows that students' knowledge and clinical skills significantly improved. More than two-thirds of the students and preceptors were thoroughly satisfied with the e-portfolio assessment. On average, each student had more than three reflections recorded.Conclusions: Using an e-portfolio assessment satisfies students and preceptors, improves surgical technologist students' knowledge and skills, and supports their progress toward achieving professional goals; therefore, it is recommended as a comprehensive and cost-effective assessment method.