BACKGROUND: As other laboratory procedures urinalysis needs accurate and precise control of test process and it could be achieved by thorough internal and external quality control measures. This study was carried out to evaluate current situation of urinalysis including urinary sediment analysis in Korea and to seek the momentum for improving the quality of urinary sediment analysis which is still carried on manually. METHODS: The evaluation was based on the analysis of the data obtained either from the External Quality Assessment in Urinalysis conducted by the Korean Association of Quality Assurance for Clinical Laboratory Urinalysis and Routine Microscopy Subcommittee (KEQAS-UA) or from the experiences of participation of CAP (College of American Pathologists, U.S.A) and Asia Photo Surveys. Also the routine measures of quality control in Department of Clinical Pathology of Seoul National University Hospital was evaluated. RESULTS: 1. The Korean external quality assessment scheme in urinalysis was begun in 1982 with the participant of 76 laboratories, which grew to 416 in 1999. 2. The Urinalysis and Routine Microscopy Subcommittee, the Korean Association of Quality Assurance for Clinical Laboratory performed one specimen included 9 items at first, which are pH, protein, glucose, ketone, bilirubin, urobilinogen, blood, nitrite, and specific gravity. 3. KEQAS-UA carried out with 3 samples in 1985, which are home-made materials, added hCG test in 1986. The samples were replaced by 4 lyophilized materials and photosurvey was added in 1987, urinary leukocyte in 1991 and one parasite sample in 1999. 4. In 1996, KEQAS-UA surveyed the performance status of urinary tests in participating laboratories in Korea. In urinalysis survey, the degree of urinary sediment performance based on centrifugation speed at 1500 rpm with direct dropping of sample on slide was excellent. But the performance of dysmorphic RBC, renal tubular cell on urinary sediment revealed not so good. 5. The total number of tests on urinalysis in 1999 SNUH was 1,292,642 on main laboratory, 15,714 on emergency laboratory, 199,323 on children's hospital laboratory. The request rate of urinalysis was increased to 19% on main laboratory, 60% on emergency laboratory, 17% on children hospital, respectively compared with the number of tests in 1993. CONCLUSIONS: Most laboratories make use of automated urinalysis analyzers for qualitative analysis in Korea. But urinary sediment was still done manually. In the near future, most of the laboratories will make use of automated urinary sediment analyzers for the purpose of turn around time reduction, improving productivity, accuracy, reproducibility, enhancing efficiency and simplifying of urinalysis work flow in laboratory.