The concept of patient-based quality control (PBRTQC) has been discussed and applied in hematology laboratories for many years, but its implementation in clinical chemistry remains limited. This is because this form of quality control (QC) requires individual optimization for each patient group and often for each analyte. Nevertheless, the obvious advantages of PBRTQC against the backdrop of realizing the limitations of traditional QC have necessitated the development of guidelines for its implementation in the laboratory. This review discusses the key components of the PBRTQC system (calculation algorithm, block size, truncation limits, control limits) and their relationship to specific analytes. It also discusses the need to optimize PBRTQC using patient data from a particular laboratory, thereby enabling timely detection of systematic errors and minimizing the false positive rate.