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Adverse event monitoring is a problem‐oriented approach to clinical audit and health‐care quality improvement, which was developed and has been widely used in the USA. Briefly explores the technique itself and its evolution. Presents experience gained from the widespread use of the approach in a British acute hospital, and results from one specialty– ophthalmology. Suggests that the study of adverse events in patient care can produce significant improvements in patients’ care,that it is particularly suited to some specialties, and that it should be used alongside other techniques in hospital clinical audit programmes. Concludes that, as the demand for quality‐monitoring information from purchasers and within providers grows, adverse event monitoring may become one of the key techniques for quality assessment and improvement.

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