This paper reports on a secondary analysis of data from an outcomes study of advanced practice nurse (APN) graduates from a university in the southwest United States. These authors describe the theme–constraints to role fulfillment–that emerged from data analysis. Interpretive phenomenology was the methodology used. All nursing masters graduates in practice for at least one year were invited to participate in the study either through a focus group or individual interview. Four themes related to constraints to role fulfillment for APNs were uncovered, including issues related to the practice setting, health care systems, legal systems, and environmental constraints. Implications for education, practice, and policy are discussed. Further research is indicated to explore the effect of various environments on APNs' ability to provide access to health care for all people in this country. Outcomes studies of APN programs can reveal helpful insights for program evaluation and continued improvement of educational programs. Support: Northern Arizona University Intramural Grant Disclaimer: An earlier version of this paper was presented at Western Institute of Nursing Conference, Albuquerque, NM, April 7, 2006