PurposeItem analysis of multiple‐choice questions (MCQs) is an essential tool for identifying items that can be stored, revised, or discarded to build a quality MCQ bank. This study analyzed MCQs based on item analysis to develop a pool of valid and reliable items and investigate stakeholders’ perceptions regarding MCQs in a written summative assessment (WSA) based on this item analysis.MethodsIn this descriptive study, 55 questions each from 2016 to 2019 of WSA in preclinical removable prosthodontics for fourth‐year undergraduate dentistry students were analyzed for item analysis. Items were categorized according to their difficulty index (DIF I) and discrimination index (DI). Students (2021–2022) were assessed using this question bank. Students’ perceptions of and feedback from faculty members concerning this assessment were collected using a questionnaire with a five‐point Likert scale.ResultsOf 220 items when both indices (DIF I and DI) were combined, 144 (65.5%) were retained in the question bank, 66 (30%) required revision before incorporation into the question bank, and only 10 (4.5%) were discarded. The mean DIF I and DI values were 69% (standard deviation [Std.Dev] = 19) and 0.22 (S.D. = 0.16), respectively, for 220 MCQs. The mean scores from the questionnaire for students and feedback from faculty members ranged from 3.50 to 4.04 and from 4 to 5, respectively, indicating that stakeholders tended to agree and strongly agree, respectively, with the proposed statements.ConclusionThis study assisted the prosthodontics department in creating a set of prevalidated questions with known difficulty and discrimination capacity.