This qualitative, descriptive study explored physiotherapists' experience of participating in peer review in public and private health services in New Zealand. Peer review is a professional activity where one health practitioner evaluates the practice of another. Accordingly, much professional effort has been expended on developing peer review systems and implementing review processes, yet the benefits of peer review are uncertain. A changing legislative environment where producing evidence of ongoing professional development is required, has provided impetus for this study given the limited research to support the use of peer review in this context. While the literature identifies competing focuses on professional development and accountability, there is lack of clarity about which model of peer review is being implemented in this country and which might serve the profession better. This study is a first step in clarifying the issues by identifying the personal, professional and organisational factors that influence health professionals' participation in peer review. The methodology consisted of a qualitative descriptive approach situated within a post positivist paradigm. Seven physiotherapists working in the New Zealand health system who had participated in a peer review process within the last 3 years participated in this study. Semi structured interviews were conducted, guided by broad questions relating to central themes identified during an extensive literature review. Interviews were then audio taped and transcribed verbatim to form the data. Transcripts were analysed by assigning content labels to units of text that seemed to encapsulate one complete thought or idea. The labelled groups were analysed into sub themes. Finally, the general themes that arose were described. Findings indicate that while peer review systems have been developed and are carried out as prescribed, therapists lack clarity about the intended outcomes. While recognising the benefits of receiving feedback on practice, many manage the review process to maintain positive working relationships and ensure their practice is favourably reviewed. The strategies they employ and the consequences of managing peer review in these ways are described. Current peer review processes in New Zealand do not provide reliable information about competence to practice. Neither do they fully achieve their potential as a professional development tool. Therefore, the professional emphasis and effort on peer review needs to be revisited. The findings highlight the need for consultation amongst individual physiotherapists, physiotherapy managers, physiotherapy professional organisations, and the registration board, to negotiate whether regulatory or professional development needs will drive peer review processes in New Zealand in the future.