The purpose of this study was to investigate the usefulness of the midcurricular HESI examination in identifying at-risk students early in their nursing program. The sample included baccalaureate nursing graduates from two university programs in the southeastern United States (n = 256). A quasi-experimental design was used to determine how well the midcurricular HESI predicted outcomes on the HESI E2 and the NCLEX-RN passing status while controlling for demographic and institutional covariates. The study used logistic regression and multiple linear regression to analyze the hypotheses. The midcurricular HESI examination was found to be a statistically significant predictor of NCLEX-RN outcome both before (P = .044) and after (P = .041) controlling for demographic factors. The study further found a statistically significant relationship between the midcurricular HESI and the HESI E2 examinations (P < .001). In the post hoc analyses, students from the Accelerated and Fast Track degree programs scored significantly higher than did students in the Traditional Track on the midcurricular HESI examination. There were no statistically significant differences in HESI E2 scores or NCLEX-RN outcomes among the degree tracks. As anticipated, there was a statistically significant difference in both midcurricular HESI (P < .043) and HESI E2 (P < .016) scores between students who passed and those who failed NCLEX-RN. This study indicates that the midcurricular HESI examination is very useful in predicting outcomes in baccalaureate nursing education programs.