Research has repeatedly demonstrated the benefits of neuropsychological evaluations to patients and their families. However, there is great potential for advancement and improvement in the field. For example, there is growing interest in improving the validity of neuropsychological tests in the assessment and prediction of complex medical conditions using biological, statistical, and informatic techniques. We discuss these issues with Robert “Bob” Bilder, Ph.D., ABPP-CN, a leader in the conceptual and technical evolution of the field. We also discuss the problem of inertia, ecological and physiological validity, item response theory, computerized neuropsychological testing, and the National Neuropsychology Network (NNN).