Purpose: This study is performed to develop the contents of career ladder program for nurses in a hospital. And this study present the appropriate strategies of career ladder program using the clinical ladder in clinical nursing field in Korea. Methods: The method of the study were modified Delphi technique with professional group for identifying nursing domains, steps of career ladder system and managerial strategy. Result: We identified tool of the nursing domains; nursing patient, quality approvement and research, development of human resources, leadership and qualifications of promotion and contents of ladder of each level. We created expected role consisted of clinical ladder and classified 4 steps; novice, competent, proficient, expert. And finally managerial principles and application process are presented in this study. Conclusions: Development of career ladder program at a hospital was not need many time consumption but very important tool of nursing profession. And it is needed to validate and refine the tool developed continuously.