It is essential to ensure that nurses are well trained and competent enough to provide safe and quality healthcare because of the critical role they play in the health systems globally. It is against this backdrop that Ghana instituted nursing licensing examination which includes clinical competency assessment. This qualitative exploratory descriptive study sought to explore and describe the perspectives of key informants on the clinical nursing competency assessment in Ghana. A total of 20 purposively selected key informants (nurse educators, nurse clinicians, and nurse managers) were interviewed. Data was analyzed using thematic content analysis. Although the intention of the clinical competency examination conducted by the nursing council is to ensure that only competent nurses are licensed to practice in Ghana, there are inherent issues such as manipulation of examiners, poor training of examiners, unstandardized assessment process, and inadequate resource which compromises the intent of the process. The nursing council admitted to not being aware of some of the challenges found in this study and will work towards improving the quality, validity, reliability, and fairness of the examination system. It is essential that the council institute quality improvement processes, including independent research into the examination process, to continually improve on the process because other countries within the sub-region try to benchmark their nursing licensing examination on that of Ghana.