This study compares nurse and manager assessments of nurse competence in a university hospital setting. Although managers carry out annual reviews, few studies have examined the agreement between the competence assessments made by practising nurses and their managers. Using a pretested 73-item questionnaire, consisting of seven competence categories, we compared self-assessments and manager assessments of the level of nurse competence on a Visual Analogue Scale of 0–100 and the frequency of using competencies by using statistical analyses. Managers assessed the overall level of competence (70.8 ± 19.3 vs. 63.9 ± 13.7) (mean ± SD) and the level of competence in five competence categories significantly higher than the nurses themselves. A high degree of agreement was found between the assessments for the frequency of using competencies. These results can be used to encourage nurses and to improve the quality of care in different hospital work environments.