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How is quality supported and what voluntary activities are there in the German statutory healthcare sector? Especially in outpatient healthcare, with a high proportion of chronic diseases treated that can significantly impair one's quality of life, quality of care is of utmost importance. We provide an overview of quality assurance measures that statutorily practicing doctors and psychotherapists (must) oblige to. Voluntary activities from third parties like doctor-specific associations and critical incidence reporting systems (CIRS) are presented alongside tools and services provided by the National and Regional Associations of Statutory Health Insurance Physicians as well as the implications of "Richtlinien" (directives) from the Federal Joint Committee and of "Qualitätssicherungsvereinbarungen" (quality assurance agreements) from the Joint Committee Quality Assurance. In summary, there is a wide spectrum of (in part voluntary) instruments and rules that is the cornerstone for the high quality present in the statutory outpatient healthcare system in Germany., (© 2022. Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature.)