We conducted an international survey in which forensic examiners who were members of professional associations described their two most recent forensic evaluations (N = 434 experts, 868 cases), focusing on the use of structured assessment tools to aid expert judgment. This study describes (a) the relative frequency of various forensic referrals, (b) what tools are used globally, (c) frequency and type of structured tools used, and (d) practitioners’ rationales for using/not using tools. We provide general descriptive information for various referrals. We found most evaluations used tools (74.2%) and used several (four, on average). We noted the extreme variety in tools used (286 different tools). We discuss the implications of these findings and provide suggestions for improving the reliability and validity of forensic expert judgment methods. We conclude with a call for an assessment approach that seeks structured decision methods to advance greater efficiency in the use and integration of case-relevant information.