As nurse practitioners (NPs) assume more autonomy and take on more responsibility, they increase their legal liability. NPs are now being held accountable to their scope of practice. The resulting dilemma is that as scope of practice and autonomy increase so, too, does susceptibility to malpractice exposure. The primary causes for indemnity payments are identified. By knowing the cause, NPs can work toward a solution that will enhance patient outcomes while simultaneously decreasing malpractice liability.