Even if the importance of the primary care has been stated both by WHO and our National Health System (in the meaning of prevention, diagnosis, treatment and rehabilitation), only recently it seems to deserve a more structured evaluation. The paper aims to deeply analyse the meaning of primary health care system within the clinical governance practice, to identify - using national and international data - the role of its appropriateness in reaching the best outcomes in terms of health and economical results and to supply the readers with some operative methods for the evaluation. According to the most recent literature and the data gathered from Italian experiences, some suggestions are given in order to improve appropriateness and quality of this first and fundamental level of the national system of care.