Since 2003, community-based plant health clinics have been established in several developing countries as a new, low-cost method to provide plant health advice to smallholder farmers who have limited access to advisory services. As the plant clinics are becoming more widespread, there is an increasing need to create basic procedures to regulate clinic operations. This paper describes how the concepts of `plant health clinic quality’ evolved from 2006 to 2009 and how a novel framework for quality assessment was developed in Nicaragua, Bangladesh, Vietnam, Bolivia and Uganda. Quality criteria for plant clinics include technical quality, timeliness, staff attitude, feasibility of advice, clinic location, materials, organization and outreach. These criteria show many similarities to those applied successfully in human and animal healthcare. Allowing plant clinic staff and their supervisors to define the quality criteria and monitoring methods themselves has helped raise awareness about clinic performance and improve self-assessment skills. Monitoring visits are being done more consciously and systematically and there are indications that register management and decision-making processes are improving as well as staff motivation. Monitoring protocols and quality assessment are now accepted as an essential component of plant clinic operations to improve clinic performance and accountability to farmers.