The American College of Obstetricians and Gynecologists (ACOG) has a two-pronged Quality Assurance program for use by practitioners. The Voluntary Review of Quality Care Program allows hospital departments of obstetrics and gynecology to be reviewed, at their own request, by a team of trained reviewers. TheQuality Assurance in Obstetrics and Gynecology Manual, published in May 1989, provides clinical indicators and clinical criteria to be used within a department to establish its own quality assurance program. It allows evaluation of a departmental practice; development of physician profiles, department profiles, and practice trends; and identification of educational needs. The planning of these programs is difficult. Setting standards and establishing quality assurance programs carries some risk, but certainly not the risk incurred by hearing, seeing, and doing nothing. We must provide a quality assurance program that changes appropriately and continuously with proven advances in science and technology.