The measurement of cholinesterase activity is an important function of a clinical laboratory. Participation in appropriate quality assurance schemes is essential in ensuring a high analytical standard. Samples of human serum were distributed to thirty-five laboratories for the measurement of cholinesterase activity. Because of methodological differences between the participants, findings of each laboratory were compared either by the use of duplicate samples or by analysis of six mixtures of two samples, one having a high and one a low activity. Of 4,964 distributed samples 95% were analysed and findings reported in 596 reports. Thirty-four percent of all reports were considered very good (less than 5% within-run error) and 38% less than satisfactory (within-run error over 10%). Access to a proficiency programme such as this enables laboratories to evaluate the quality of their analytical service.