The last decades have witnessed an increased concern in higher education over accountability, quality and productivity, and a struggle to meet increasingly complex challenges. This is more so in Middle East and North African (MENA) economies that witnessed a large expansion as a result of a high social demand and massification policies adopted by governments in public institutions. These policies also allowed the private sector to expand to meet the increasing demand. As a consequence, higher education institutions were faced with serious challenges related to quality because the quantitative expansions took place at the expense of quality (UNESCO, 2010). Although 14 out of 20 MENA economies established national bodies for quality assurance and accreditation, quality issues are still challenging higher education institutions in the region. The author presents the achievements, challenges and issues in quality in higher education in the region. She also briefly presents several international organisations' initiatives and perspectives on quality in higher education in the region, and attempts to propose a set of suggestions and recommendations to move the systems to higher standards that are compatible with international ones. This paper covers the following 20 economies in the MENA region: Algeria, Bahrain, Djibouti, Egypt, Jordan, Kuwait, Lebanon, Libya, Mauritania, Morocco, Oman, the Palestinian Authority, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, United Arab Emirates, Yemen. Please note that wherever the term "the region" is used in the article, it refers to these economies.