Clinical performance assessment (CPA), which includes performance criteria, that define what students are expected to learn and practically demonstrate, is used to declare students competent by determining their level of skill. The purpose of this research was to explore student perceptions on the clinical assessment and how assessment contributed to enhancement of competency, and was driven by the question “How do oral hygiene students’ perceptions on clinical performance assessment (CPA) influence their learning experience?” A qualitative approach was followed, rooted in an interpretivist paradigm, using a case study design. The sample consisted of all 19 second-year oral hygiene students who wrote a narrative, and four of the 19 students with whom semi-structured interviews were held. Data was collected by asking the students to write the narratives, and after analysis thereof, the interviews were held. Data was analyzed throughout the data collection process, using a coding framework. The oral hygiene students understood that CPA tested their clinical skills as well as their theoretical knowledge, measures progression and improvement. They expressed negativity about the assessors' inconsistent use of performance criteria, inadequate feedback, and the unprofessional relationship of certain assessors with them. These issues led to frustration, confusion, and demotivation, and impacted negatively on students' learning and competency. Being humiliated in front of the patient or being shouted at led to demotivation. Students coped with assessment by adapting to what an assessor wanted, focusing on patient feedback, and just accepting the results. Students recommended that there be more feedback and discussion with the assessor about strengths and weaknesses. This was how they learned and became competent. They should be allowed to express an opinion and discuss issues with the assessor.