Quality management (QM) is essential for modern nuclear medicine departments. This publication presents a method of conducting a systematic annual audit process. A key outcome of the QM methodology should be a culture of reviewing essential elements of the clinical service. Each chapter of this publication is set out as a series of questions related to specific components of the nuclear medicine service. The diversity of the nuclear medicine service and the multidisciplinary nature of the contributions (including clinical, technical, radiopharmaceutical and medical physics procedures) are considered. The QM methodology described in this publication is designed to be applied to a variety of economic circumstances and will be of use to those involved in the development or implementation of QM systems.