This study identifies competencies and accompanying skills, knowledge, and abilities (SKAs) required by the Veterans Health Administration (VHA) nurse executives. Using the Delphi decision-making method, 144 VHA directors of nursing identified five top competencies necessary for nurse executives. An expert panel sorted competencies into the eight core domains of the VHA high-performance development model. Next, nurse executives rated SKAs by using a 7-point importance scale. Response rates were 34% and 48.2% for Delphi rounds 1 and 2, respectively. Round 1 generated 245 unique nurse executive competencies. In round 2, the highest rated SKAs involved ethical conduct, decision-making, abilities to continuously learn and lead, staffing, and conflict-resolution skills. Competency list outcomes are expected to be useful for executive self-assessment, professional development, and identification of continuing education needs. Specific SKAs can provide a means for development of job requirements and career performance criteria.