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Although colonoscopy has been demonstrated to reduce colorectal cancer (CRC) incidence and mortality, variability in the quality of colonoscopy has been linked to adverse patient outcomes, including post-colonoscopy CRC. High-quality colonoscopy includes adequate bowel cleansing, safe insertion of the colonoscope to the cecum, a detailed examination of the mucosa with identification and resection of neoplasia, appropriate follow-up recommendations, and accurate and complete procedural documentation. Colonoscopists may master the performance of some aspects of colonoscopy but may be inadequate in others. Thus, deficiencies in performance can have severe consequences, highlighting the importance of quality measurement and interventions to address any identified performance gaps. In this chapter, we provide an overview of colonoscopy quality indicators that have been recommended by the American Society for Gastrointestinal Endoscopy American College of Gastroenterology Quality Task Force and the European Society of Gastrointestinal Endoscopy and United European Gastroenterology.