Occupational health nurses must have a growing, expanding knowledge base to remain current in practice. The Ameri- can Board for Occupational Health Nurses, Inc. encourages advancement with the availability of certification exami- nations. Health care centers support clinical advancement programs for bedside nurses. Nurses who continue their education either through a degree program or via continuing education or certification advance up the clinical ladder, receiving a higher salary, recognition from their peers, and perhaps even financial assistance to continue climbing, yet occupational health nurses do not have their own clinical advancement ladder. This article examines the steps neces- sary to develop a clinical ladder and presents a clinical ladder specific to occupational health nursing developed by the author.