There is a dearth of evidence focusing on student preferences for computer-based testing versus testing via student response systems for summative assessment in undergraduate education. This quantitative study compared the preference and acceptability of computer-based test- ing and a student response system for completing multiple choice questions in undergraduate nursing education. After using both computer-based testing and a student response system to complete multiple choice questions, 192 first year undergraduate nursing students rated their preferences and attitudes towards using computer-based testing and a student response system. Results indicated that seventy four percent felt the student response system was easy to use. Fifty six percent felt the student response system took more time than the computer-based test- ing to become familiar with. Sixty Percent felt computer-based testing was more users friendly. Seventy Percent of students would prefer to take a multiple choice question summative exam via computer-based testing, although Fifty percent would be happy to take using student re- sponse system. Results are useful for undergraduate educators in relation to student's prefer- ence for using computer-based testing or student response system to undertake a summative multiple choice question exam.