This critical review questions the present understanding in monitoring of analytical quality control in neonatal screening. Current status and historical background of the analytical quality control, particularly of the tests intended for the screening of congenital hypothyroidism and some inborn errors of metabolism, is reviewed. The reasons why attempts to standardize immunoassays through the preparation of a so-called ''gold standard'' (e.g. for thyrotropin) will not resolve noncomparability of results are discussed. The review presents arguments for the necessity of elaboration of international guidelines for methods assessment and comparison with an emphasis on their clinical relevance.