Accreditation and quality assurance frameworks are increasingly employing principles of developmental and responsive quality procedures to help improve quality and not just conformity with state requirements. National quality assurance and accreditation bodies across the region have established their procedures in relation to institutions’ capacity for self-assessment and internal monitoring of their programmes. These developments are expected to reduce control burden and build trust in the higher education system. But the growing market of higher education in the Balkans and particularly the one of private providers has emphasised the role of accreditation mainly as a license for operation instrument. At present many private providers express concerns that accreditation regimes in their countries have turned into mere inspection seeking compliance rather than quality assurance and are incapable of ensuring the integrity, reliance and genuine European recognition of higher education qualifications. This paper investigates approaches to quality assurance of higher education in selected Balkan countries, and identifies challenges faced by their accreditation agencies in adopting European standards for quality in their work. The insights gained from this study into the accreditation practices in selected countries in the region (Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Greece, FYROM, Kosovo, Montenegro, Romania, Serbia, Slovenia and Turkey) could be used to inform further research into the development of higher education quality assurance approaches and institutional reform strategies in the respective countries, as well as in the ACEU member institutions.