All practitioners who perform surgery are familiar with the surgical timeout checklist, the third component of the Universal Protocol that was introduced by the Joint Commission and became a mandatory quality standard in 2004. Many other checklists are used in healthcare, but there is a lack of standardized methodology for the development and design of medical-specific checklists (Hales et al, Int J Qual Health Care 2008). Healthcare entities are increasingly moving towards becoming high reliability organizations (HROs), taking cues from other HROs such as the aviation and nuclear power industries. Because of this move, the use of checklists is increasing, but with that, checklist fatigue is also increasing. This panel discussion will start with an overview of general principles when assessing the literature. The majority of the panel will be a pro versus con debate surrounding the usefulness and effectiveness of checklists in improving quality and preventing harm events. The guidelines of the debate will be the respectful interchange of information with equal time being given to each side. The presentation will conclude with a review of how checklists have been used in Otolaryngology specifically to address errors and adverse events, and how the checklist process might be improved to decrease fatigue and improve outcomes.