This paper presents a prospective cross-sectional study that investigated the tenure rate and the primary criterion use in granting tenure in nursing and allied health education in the United States of America. Given the recent trend by highly skilled professionals to seek employment in other countries, a clear understanding of the conditions of service in higher education is important to educators contemplating the relocating to another country. The preponderance of the published literature on academic tenure is from the United States of America, where educators continue to debate the value of the tenure system and the criteria to be used in tenure decisions. We surveyed the deans of National League for Nursing accredited programmes (n = 187) and deans of allied health programmes belonging to the association of schools of allied health professions (n = 75) in the United States of America. The questionnaire sought demographic and institution-related information, tenure rate and weightings attached to teaching, scholarship and service in tenure decision. The data were collected in 2002. Allied health and nursing educators had 47% and 35% tenure rates, respectively. The overwhelming majority of the deans in our study, 77%, ranked teaching as the primary criterion used in tenure decisions in their institutions. On the other hand, fewer than 25% rated scholarship and fewer than 5% rated service as the most important criterion used for tenure in their institution. The responses of the deans were modulated by the type and ownership of the institution in which they were employed and the characteristics of the educators. The implications for preparing future educators in the United States of America for long-term careers in allied health and nursing professions are that: (1) teaching is less highly valued in research-oriented universities; and (2) heavy teaching workloads may be detrimental to the chances of obtaining tenure. Replication of the study in other countries would have the potential to facilitate the employment mobility and educator exchange.