Purpose of review <p>Advances in the understanding of esophageal diseases as well as the diffusion of new technology for both diagnosis and treatment have increased complexity and variability in care delivery. As a result, there is an increasing motivation to monitor and improve care by tracking established quality metrics. This review will summarize the quality indicators and measures currently used for both benign and pre-malignant esophageal diseases focusing on endoscopic quality.</p> Recent findings <p>Endoscopic quality metrics exist for gastroesophageal reflux disease (GERD), eosinophilic esophagitis (EoE), achalasia, and Barrett’s esophagus (BE). The focus of these metrics is on consistent photodocumentation, use of validated classification systems, and emphasizing a standardized approach to tissue sampling. However, adherence to current best practices is suboptimal. In addition to quality improvement efforts, best practices for adjunctive testing during endoscopy, such as functional luminal imaging probe (FLIP), are needed.</p> Summary <p>While management recommendations and evidence-based guidelines from professional gastrointestinal societies have been translated into quality metrics to improve care delivery, there remain opportunities for improvement in care and wider adoption of monitoring outcomes. Future work should address strategies to augment adherence and methods to track quality for novel technology.</p>