Psychological tests have been used for decades in the selection of pilots to determine whether they have the required cognitive skills, flying aptitude, temperament and personality to succeed as a pilot. This chapter reviews the utility, reliability and validity of neurocognitive testing and make recommendations for the future. There are two main contexts in aviation in which neurocognitive assessments may be undertaken: as part of the competitive selection process for pilots or because a potential neurological/health problem is suspected. For safety reasons it is important to identify pilots who are cognitively impaired, and a particularly effective method of doing so is neuropsychological assessment. This type of specialist neurocognitive testing differs from online testing in several important ways. Clinical neuropsychologists evaluate individuals using a variety of means, one of which is neurocognitive testing. Clinical neuropsychologists interpret the results of neurocognitive testing in the context of information obtained from other medical professionals and review medical, educational and occupational records.