Portfolios have gained attention in medical education as a tool for promoting student learning and assessment since Miller’s call for better tools for assessing students’ clinical competencies. This paper reviews the development and use of e-portfolios for promoting learning and assessment in medical schools, both domestically in Korea and internationally. This review finds that some specific features need to be incorporated into e-portfolio systems for medical education and that these systems can be used to manage student learning in clinical clerkships and to support competency-based assessment. The author asserts that the e-portfolio is key to promoting competency-based education and suggests practical tips for effective development and use of e-portfolios in Korean medical schools