Certain areas of the United States have decided to credential community health workers (CHWs) for varying reasons. Massachusetts is now at a critical juncture to make decisions on whether to credential CHWs, and if so, what would be the best model for CHWs in the commonwealth. These conversations began as a result of Section 110 of the Health Care Reform Law of 2006 which mandates the Department of Public Health, with the assistance of the CHW Advisory Council, to provide recommendations to the legislature about a CHW certification program. In order to make an appropriate decision for Massachusetts it is important to understand why certain areas of the US chose to credential CHWs, what are the possible benefits and concerns of credentialing CHWs, who needs to be part of these discussions, and recommendations for the future.