Lithuania's upper secondary certification – the Matura – transformed teaching and learning when it was introduced, by providing a trusted, reliable and objective measure of student achievement. A decade later, while the Matura continues to be a respected national institution, the country is reviewing its design so that it consistently promotes higher-order skills for all students. This chapter considers three key issues in the Matura – item development and analysis; assessing a broader range of skills in reliable and valid ways; and providing greater flexibility to be responsive to learners’ personalised pathways. Each issue is presented first in terms of the wider context that influences the issue, followed by options that provide recommendations for the country to consider.