Clinical governance represents a comprehensive, systematic approach to ensuring and enhancing the quality and safety of patient care within healthcare organizations. Originating in the United Kingdom in the late 1990s as a response to critical failures in patient safety, it establishes a framework of accountability, continuous quality improvement, and evidence-based clinical effectiveness. Core elements of clinical governance include patient safety, risk management, clinical audit, staff education, patient involvement, and information management. These components collectively foster a culture of transparency, professional responsibility, and proactive prevention of errors. The framework demands multidisciplinary collaboration among healthcare professionals and administrative leadership, ensuring integrated oversight and shared commitment to clinical excellence. Clinical governance principles have since been adopted and adapted worldwide, influencing healthcare systems in countries such as the United States, Australia, Canada, and across Europe, as well as in low- and middle-income countries with variable implementation levels. Practical applications demonstrate measurable improvements in patient outcomes, including reduced surgical site infections, enhanced medication safety, and improved maternal care. This chapter also outlines the organizational structures and leadership roles critical for successful governance, including clinical audit committees and risk management teams. By embedding continuous monitoring, learning from incidents, and patient feedback into everyday practice, clinical governance remains essential in driving safe, effective, and patient-centered healthcare services, adapting to evolving challenges like digital health integration and complex care models.