Quality management in anesthesiology represents the convergence of patient safety, evidence-based medicine, and systems leadership. As perioperative physicians, anesthesiologists are uniquely positioned to influence clinical outcomes, operational efficiency, and institutional strategy. This chapter explores the expanding scope of anesthesiology in quality improvement—from developing and implementing evidence-based protocols to leading national registry reporting and performance benchmarking. It discusses the anesthesiologist’s role in defining meaningful metrics, integrating real-time data analytics, and aligning departmental initiatives with hospital-wide value-based purchasing and accreditation frameworks. This chapter also examines the economic and cultural dimensions of quality, highlighting how anesthesiologists create measurable improvements in safety, satisfaction, and cost-effectiveness. Finally, it addresses future directions, including the integration of artificial intelligence, predictive analytics, and advanced informatics in perioperative quality programs. Through these efforts, anesthesiologists continue to serve as architects of safer, smarter, and more sustainable perioperative systems.