Quality is a difficult concept to define and operationalise for measurement purposes. A majority of countries do not systematically collect information on quality and many have not reached a national consensus regarding which indicators ought to be collected and reported regularly. The measurement of quality is held back by definitional and methodological challenges and the lack of a mandate to collect these data. This chapter discusses these challenges by documenting the approaches to measure long-term care quality in a selection of OECD countries, evaluates the advantages and limitations of the indicators used, and provides recommendations for the development of indicators to monitor LTC quality across OECD and EU countries.