The Spaceflight Cognitive Assessment Tool for Windows (WinSCAT) was developed by an integrated product team as a tool to support medical operations at NASA Johnson Space Center and as way to monitor the neurocognitive status of space crews. It is based on 20 yr of experience in performance and cognitive testing within the U.S. Department of Defense. As a result, WinSCAT development has benefited from diverse efforts supporting its technical reliability and validation. The rationale, background, and development of WinSCAT are described, research supporting its use is summarized, and recommendations are made for its continued development.