It remains unclear where the Veterans Health Administration (VA) finds itself in the spectrum of care currently available in the United States. The quality of care provided by the VA has been subject to debate since, and well before, the VA's system transformation starting in the mid-90s. Media and entertainment vehicles have, rightly or wrongly, not infrequently portrayed VA care in less than optimal light, although there have been notable exceptions1. Regardless of media views, the VA has established itself as an innovative healthcare system, including implementation of its advanced electronic medical record, with broad clinical and educational missions. The immediate objective of this project is to conduct a systematic literature review of the published literature comparing the quality of medical and surgical care provided by the VA to relevant non-VA healthcare facilities and systems. The Key Question was: Compare and contrast studies that assess VA and non-VA quality of care for surgical, nonsurgical and other medical conditions.