The present chapter deals with the variants of grading schemes that are applied in current Multiple-Choice Questions (MCQs) tests. MCQs are ideally suited for electronic examinations, which, as assessment items, are typically developed in the framework of Learning Content Management Systems (LCMSs) and handled, in the cycle of educational and training activities, by Learning Management Systems (LMS). Special focus is placed in novel grading methodologies, that enable to surpass the limitations and drawbacks of the most commonly used grading schemes for MCQs in electronic examinations. The paired MCQs grading method, according to which a set of pairs of MCQs is composed, is presented. The MCQs in each pair are similar concerning the same topic, but this similarity is not evident for an examinee that does not possess adequate knowledge on the topic addressed in the questions of the pair. The adoption of the paired MCQs grading method might expand the use of electronic examinations, provided that the new method proves its equivalence to traditional methods that might be considered as standard, such as constructed response (CR) tests. Research efforts to that direction are presented.