In developed countries, the application of the quality management system (QMS) is widely proven. However, in developing countries, like Pakistan, industries are not mature enough to understand and implement the system. The aim of this study is to examine the perception of quality, implementation of QMS and cost of quality (COQ) program in value-added garment sector, which is one of the major subsectors of textile industry in Pakistan. The methodology of the study is a questionnaire survey. The findings suggest that the majority of the respondent firms have well implemented quality management (QM) practices. Trend of results also depicts that most of the organizations wish to acquire ISO certification, which shows that the industrial processes are customer-centered thus striving to fulfil customer requirements. It can also be concluded that most of the organizations lack the COQ concept, its understanding and appropriate implementation.