Defining and measuring healthcare quality and examining the factors that affect it are necessary to optimize health outcomes. Tools such as quality indicators and patient-directed evaluation instruments can serve to identify targets for improvement. Although the quality of healthcare for a variety of medical conditions has received increasing attention, few have attempted to measure and improve the quality of care for patients with rheumatic illnesses. This article reviews the efforts specific to musculoskeletal disease to standardize performance measurement tools. It also discusses recent quality improvement efforts targeting both structural and process components of healthcare delivery systems for arthritis and related conditions.