The higher education community and institutions of higher learning generally approve of a voluntary peer review process for quality assurance. In thinking about accreditation, it is important to keep in mind that U.S. higher education is not monolithic and that the various institutional sectors do not necessarily agree on what the process of peer review should entail. The higher education community supports peer review and institutional improvement as a means of assuring quality, but debates what should be involved. The federal government seeks to protect the public interest and the public purse through accountability, transparency, and compliance with regulation. All of this produces ongoing tensions in and for accreditation. In this article, the author discusses whether an accrediting agency should focus their review on institutional improvement or on compliance.