Purpose An operative performance rating system (OPRS) for Urology residents was developed for 6 sentinel urological procedures. This study tests the reliability, validity, and feasibility of an OPRS for Urology residents. Materials and Methods Each procedure OPRS contained a 3-point case difficulty scale, 4 to 6 procedure specific items, 3 general items, and an overall performance item. A Likert scale of 1 to 5 was used for each item. A single video/audio record of each procedure was evaluated by the faculty, and single-item inter-rater agreement was measured by comparison of the observed