For many years quality assurance has been well established in industry. At the same time, quality assurance in the medical services has become more important. The present study was limited to aspects of quality assurance in general and pediatric audiology. Typical quality requirements were defined for these services and quality features established. International recommendations were available as far as the quality of the equipment and methods used was concerned. Strategies to optimize the relationship between the reliability of diagnosis and additional costs are presented in order to improve the quality of the processes involved. Procedures to check the qualitative effect of rehabilitative interventions used are available but not yet standardized. The different audiometric procedures employed and corresponding international recommendations are summarized.