The principles of Continuous Quality Improvement (CQI) continue to gain acceptance as a means of improving health care delivery. They are especially appropriate in the out patient management of a chronic progressive disease such as multiple sclerosis (MS). This paper reviews why CQI facilitates care with this type of disease; discusses how one clinical facility, The Cleveland Clinic Foundation Mellen Center for Multiple Sclero sis Treatment and Research, has implemented these principles in defining and revising our general clinical operation; and describes how these same techniques are useful in developing (a) administrative strategies and (b) a treatment plan for one individual. Key Words: Multiple sclerosis—Continuous quality improvement—Comprehensive care.