As far as the Italian manufacturing sector is concerned, the widespread adoption of advanced managerial criteria dealing with non-price factors (essentially, tailoring and servicing), market orientation and the value-driven approach lead corporate mindsets to pay growing attention to quality improvement, the ultimate weapon to capture and maintain dominance in the market. However, the analysis of experienced quality initiatives shows that Italian small and medium sized enterprizes (SMEs) prioritize process capability improvement, thus applying appropriate techniques and operative tools, rather than re-engineering the whole company organization, focusing on interactions with the external environment (suppliers, target markets, technological networks, public bodies etc.). In this view, product quality—depending more and more on service content and relationship abilities—comes to be meaningfully affected by production systems which scarcely implement a company-wide quality control (CWQC) strategy. This weakness of Italian quality vision has heavily penalized the development of courses of action which effectively streamline working practice and increase the SMEs' competitive advantage. This paper provides a critical analysis of quality implementation in Italian industry, taking into consideration the major structural components and cultural factors which have influenced, and still do, the behaviour of SMEs. Moreover, special emphasis is given to the most suitable interventions for stimulating the principle of quality enhancement and encouraging the use of operational tools in daily activity.