What Is the Passing Score for the ATLS Exam? (2026 Guide)

The short answer: 75% on the written post-test — and that isn't the whole requirement

The only passing threshold the American College of Surgeons publishes for ATLS is a minimum post-test score of 75%. The official course listings on learning.facs.org put it plainly: CME will only be granted upon successful completion of the course with a minimum post-test score of 75%.

That single figure gets quoted constantly, usually stripped of its context. So here's the context. Clearing 75% on the multiple-choice post-test does not, by itself, complete the course. ACS describes completion as requiring a passing grade on the written examination together with demonstration of appropriate skills, knowledge, and attitudes at the skills stations and in the initial-assessment scenario. You can ace the paper and still not finish the course if you can't run a primary survey under pressure with a resuscitation team watching.

If you've come here because you're worried about the written portion specifically, it's worth reading our breakdown of how hard the ATLS exam actually is alongside this page — the difficulty and the scoring rules are two different conversations.

What ACS publishes, and what it deliberately doesn't

A lot of the confusion around ATLS scoring comes from third-party course sites, prep blogs, and forum posts filling in blanks that ACS has left blank on purpose. Being clear about which is which saves you a lot of anxiety.

Detail	Status
Minimum written post-test score	Published by ACS: 75%
Skills and scenario assessment	Published as a requirement, graded pass/fail against course criteria
Number of items on the post-test	ACS does not publish the number of items on the ATLS written post-test; third-party sites commonly cite "~40 multiple-choice questions," but this is not an ACS figure
Count of scored items	Not published by ACS. The post-test is scored pass/fail against a 75% minimum, but ACS does not disclose a scored-item count
Unscored or pilot items	N/A — the post-test is a course quiz, not a standardized board exam, and ACS publishes no unscored or field-test item count
Clock time for the written post-test	Not published by ACS; treat any specific minutes figure you see online as unverified
National pass rate	N/A — ACS does not publish a national ATLS pass rate. ATLS is a competency-based course with on-site remediation, not a standardized exam with a reported pass-rate statistic
Retake or attempt limit	ACS does not publish a public numeric retake limit; candidates who don't meet a requirement are directed to their course coordinator or director and the ATLS policy manual
Course fee	Not published as a single national price; cost varies by the verified course site or host institution

None of those gaps are oversights. ATLS is a provider course run through approved sites worldwide, and the operational details sit in the ATLS policy manual and with the course director rather than in a public candidate handbook.

About that "80%" figure floating around

You will see 80% cited as the ATLS passing score on plenty of websites, sometimes on course-site pages that ought to know better. No ACS source states it. Don't attribute 80% to ACS, and don't build your study plan around a number nobody at the College has published.

What can happen legitimately is that an individual course site sets expectations above the ACS floor, or that a national ATLS organization outside the United States applies its own standard. If your course center tells you something different from 75%, that's a local requirement — ask them to point you to it in writing rather than assuming the internet is right.

How the scoring actually works: fixed criteria, not a curve

This matters more than most candidates realize. The ATLS post-test is not scaled, equated, or curved against the rest of your class. There's no standard-setting panel producing a shifting cut score from one administration to the next, and no scaled score gets reported back to you. It's a fixed criterion: hit the published minimum on the written test, and separately demonstrate competency in the practical component.

The written component

Multiple-choice, drawn from the material in the 11th Edition course manual and the required online pre-course modules. You complete a pretest before the in-person portion; the post-test comes at the end. Both are course instruments, not board exams.

The practical component

Skills stations and the initial-assessment scenario are graded pass/fail on whether you demonstrate the expected skills, knowledge, and attitudes. Instructors are watching sequence and priority — whether you protect the cervical spine while you manage the airway, whether you actually control hemorrhage before you go hunting for the interesting injury, whether you communicate as a team leader rather than a solo operator. Our piece on what an ATLS assessment involves goes deeper on what the graders are looking for.

Attendance is part of it too. You're expected to attend the entire in-person portion per your course center's schedule and to have finished the pre-course work before you arrive.

What happens if you fall short

ACS does not publish a public numeric retake or attempt limit for the ATLS post-test. If you don't meet a course requirement — written or practical — you're directed to your local course coordinator or course director, who works from the ATLS policy manual on remediation and retesting.

In practice, that usually means the conversation happens on site, the same day or shortly after, while the faculty who watched you are still present. Remediation is built into the model; the course is designed to get clinicians to competency, not to fail them out. But the specifics — what remediation looks like, when a retest is offered, what happens after that — belong to your course center and the policy manual, not to a blog post.

Does the passing standard change by course format?

ACS lists ATLS 11 formats as Traditional (2 Day), Hybrid (1.5 Day or 1 Day), and Refresher (1 Day or 0.5 Day), each in CME and Non-CME versions, all preceded by required online modules and a pretest. The Hybrid formats shift didactic content online ahead of a shortened in-person day; every format still includes hands-on skills and scenario work. The published minimum post-test score of 75% is tied to CME award across these listings — the format changes how you get there, not the standard. The MyATLS app supplements the course but does not count toward credit or completion. For more on the day-to-day shape of each option, see how long the ATLS exam and course run.

What clearing the standard actually buys you

ATLS verification status is current for four (4) years from the date you complete a Traditional, Hybrid, or Refresher course. After that, a Refresher course renews your status, with a 6-month grace period after expiration. It's a course-completion provider credential — verified status — not a board certification or a license, which is a distinction worth keeping straight when you're filling out credentialing paperwork.

The audience is health care clinicians involved in the evaluation and treatment of the injured patient: physicians and advanced practice providers, primarily, though some sites enroll other qualified providers depending on local practice. Beyond the student or provider track, there are ATLS Instructor courses; ATLS Educators are required to teach at least four ATLS Instructor courses within a four-year period to remain verified.

How to make 75% a non-event

Most people who struggle with the written post-test didn't do the pre-course modules properly. That's the honest diagnosis. The material tested is the material in the manual and the online content, organized around initial assessment, the primary survey with resuscitation, the secondary survey, airway and ventilatory management, shock and hemorrhage, thoracic trauma, abdominal and pelvic trauma, head and spine trauma, musculoskeletal trauma, thermal injury, special populations, team function and communication, and transfer to definitive care. Item weighting across those topics isn't published, so treat all of it as fair game.

Three habits do most of the work:

• Learn the sequence, not just the facts. Nearly every question and every scenario rewards knowing what comes first. If two answers are both clinically reasonable, the ATLS answer is the one that respects the order of the primary survey.
• Read the rationale on wrong options. The distractors in trauma questions are usually correct interventions performed at the wrong time. Understanding why they're premature is the actual lesson.
• Rehearse out loud. Say your assessment steps as you'd say them in a scenario station. It hardens the written recall and prepares you for the practical component simultaneously.

Our walkthrough on how to pass the ATLS exam lays out a week-by-week approach if you want more structure than that.

Before you register, confirm these locally

Courses run at ACS-approved (verified) ATLS course sites, and you register and schedule through the local site or learning.facs.org rather than against a national test-date calendar. Facilities have to be formally approved by their State or Provincial Committee on Trauma chair and/or ACS before they can offer courses. ACS reports more than 50,000 learners a year across 80+ countries, so availability varies enormously by region.

Two things to ask your course center directly: what the course costs, since fees aren't published as a single national price and vary by host institution, and what their local remediation process looks like. Everything else — the 75% minimum, the pass/fail practical, the four-year verification — is set at the program level and won't change from site to site.