As assessments move from traditional paper-pencil administration to computer-based administration, many testing programs are incorporating alternative item types (AITs) into assessments with the goals of measuring higher-order thinking, offering insight into problem-solving, and representing authentic real-world tasks. This paper explores multiple applications of AIT items and the psychometric properties of these items, including item response time, difficulty, item-total score correlations, and distractor analyses. The appropriate use of these items is also discussed in the context of professional credentialing exams.