Many challenges exist for high-stakes testing programs offering continuous computerized administration. The automated assembly of test questions to exactly meet content and other requirements, provide uniformity, and control item exposure can be modeled and solved by mixed-integer programming (MIP) methods. A case study of the computerized licensing examination of the American Institute of Certified Public Accountants is offered as one application of MIP techniques for test assembly. The solution illustrates assembly for a computer-adaptive multistage testing design. However, the general form of the constraint-based solution can be modified to generate optimal test designs for paper-based or computerized administrations, regardless of the specific psychometric model. An extension of this methodology allows for long-term planning for the production and use of test content on the basis of an exact psychometric test designs and administration schedules.