Total quality management (TQM) has been adopted in the U.S. as a way of management strategies by private enterprises as well as by the public sector. The ultimate goal of all quality management techniques and strategies is to improve quality by reducing waste, improving production process, and involving all members of the company in quality management. The purposes of this study are to review the performance of TQM activities and, based on the results, practically examine whether TQM is necessary or not in enhancing the performance of medical service institutions (hospitals) by assessing the status of TQM activities of medical service institutions and comparing such activities. A questionnaire survey was conducted against employees working for general hospitals in Seoul and other provincial areas. The questionnaire contained organized questions that were answered in writing by the target employees. A total of 184 questionnaires were collected and analyzed. The results of this study are summarized as follows. First, TQM activities and performance were found to be positively correlated. Second, TQM activities and performance differed according to ownership types. Third, TQM activities and performance differed according to geographical locations. Fourth, TQM activities and performance differed according to leadership types.