An increasing emphasis on health professional competency in recent times has been matched by an increased prevalence of competency-based education models. Assessments can generate information on competence, and authentic, practice-based assessment methods are critical. Assessment reform has emerged as an academic response to the demands of the pharmacy profession and the need to equip graduates with the necessary knowledge, skills and attributes to face the challenges of the modern workforce. The objective of this review was to identify and appraise the range of assessment methods used in entry-level pharmacy education and examine current trends in health professional assessment. The initial search located 2854 articles. After screening, 36 sources were included in the review, 13 primary research studies, 12 non-experimental pharmacy research papers, and 11 standards and guidelines from the grey literature. Primary research studies were critically appraised using the Medical Education Research Study Quality Instrument (MERSQI). This review identified three areas in pharmacy practice assessment which provide opportunities for expansion and improvement of assessment approaches: (1) integrated approaches to performance assessment; (2) simulation-based assessment approaches, and; (3) collection of validity evidence to support assessment decisions. Competency-based assessment shows great potential for expanded use in pharmacy, but there is a need for further research and development to ensure its appropriate and effective use.