The importance of preschool quality in Sweden is a subject of concern for preschool workers, researchers, parents and other stakeholders internationally. After the revision of the national preschool curriculum in 2010, the examination of the role of heads in outlining and maintaining quality has become a topic of concern, in particular regarding systematic quality work and the responsibilities of the heads in relation to this work. The purpose of this literature review is therefore to examine the extant research on how preschool heads in Sweden understand and work with the issue of quality in Early Childhood Education and Care. The research questions are: What is preschool quality, and how can it be assessed in the eyes of the head preschool teachers in Sweden? And, how do the heads fulfil their responsibilities inrelation to quality work in preschool? Four studies were reviewed and analyzed based on three criteria of measuring quality: structural,result,and processual. The results showed that the preschool heads had broad areas of measuring quality work, covering all three areas of quality. However, their practical quality work only covered some of these areas. Collaboration with staff, parents and other preschools wasmost commonly mentioned by the heads, as they are also problematised on their daily tasks in practice. Generally, there was an emphasis on structural quality more than processual and result quality matters. The findings and implications are discussed also in terms of the three areas of measuring quality: structural,result,and processual. Overall, heads might need more support and guidance from experts in order to achieve quality work in relation to processual areas of quality matters in preschool. Future research ought to examine quality of care in preschool (rather than quality of education) from the perspective of preschool heads.