Previous research on assessing the performance of college and university presidents reveals little about the procedures used or the consequences of those reviews, beyond that most presidents are evaluated annually by the governing board. Much of the literature is based on anecdotal evidence and claims that reviews are often poorly conducted and harmful to presidents. Though the practice is widespread, and potentially destructive, little is known about presidents' experiences with performance reviews. This study posed three research questions: 1) What are the processes used to evaluate the performance of academic presidents?; 2) What are the outcomes of these reviews, according to presidents and board chairs?; and 3) What are the relationships between how assessments are conducted and the outcomes reported? A national survey was conducted, using questionnaires developed by the researcher; respondents included 1,348 college and university presidents (64 % response rate) and 535 governing board chairs (33% response rate). Findings revealed that most presidential assessments were confidential, limited in participation to trustees, completed in about one month, included a self-assessment statement and face to face meetings with members of the board, and resulted in an increase in compensation. This described an informal review process and was similar to the process recommended for most corporate CEOs. Contrary to the claims of critics, most presidents were satisfied with the way their review was conducted and found it to be useful; very few presidents or board chairs reported any negative impact for presidents from reviews. Bivariate analyses revealed that the most useful reviews for presidents were those that: provided the president with more adequate performance feedback from the board; were conducted less than once a year; and were used to set goals, clarify criteria for good performance, and evaluate performance against agreed upon goals. Presidents were most satisfied with reviews which were used to set goals and clarify criteria for good performance, and allowed greater participation of presidents in the review process. Significant relationships were also found between: presidents seeking critical performance feedback and both higher performance ratings and greater improvement in performance; and residents seeking positive performance feedback and lower performance ratings . Based on the research and data, the study suggests that: presidential assessments should have as the primary purpose improving the president's performance; presidents should be actively involved in developing the process and conducting the review, including a self-assessment statement; reviews should be used to plan future goals and agree upon the criteria for evaluating future performance; previously agreed upon goals should be used as criteria; presidents should routinely receive performance feedback from the board; boards should consider less frequent, more thorough reviews; and presidents should actively seek critical performance feedback, but avoid asking for positive feedback.