The next step in the evolution of the organizational quality field, Lean Six Sigma (LSS) has come of age. However, many challenges to using LSS in lieu of, in conjunction with, or integrated with other quality initiatives remain. An update on the current focus of quality management, covers the concepts and principles of Lean Six Sigma and its origins in quality, total quality management (TQM), and statistical process control (SPC), and then explores how it can be integrated into manufacturing, logistics, and healthcare operations.