This article reports on research to form an understanding of how to account whether and how quality management (QM) has been adopted in Greek higher education. Greece only recently introduced quality assurance policies. In this study, I will describe governmental reforms related to QM policies until 2010. An issue that is frequently addressed concerns the role of leadership for the implementation and facilitation of QM. Therefore, the study will also discuss how leaders (rectors and vice-rectors) in Greek universities perceived external environmental pressures and to what extent they adopted (or not) QM. Neo-institutional theory has become a dominant approach for explaining how organizations adapt to institutionalized pressures for change of their business theory from their environments and has been applied to different organizational phenomena; therefore, in order to explain why Greek higher education institutions adopt QM I used the neo-institutional theory. (Contains 5 tables, 2 figures and 1 note.)