Quality Management Excellence represents a continuous commitment to surpassing customer expectations through systematic improvement, standardization, and effective leadership. In the digital era, Quality 4.0 builds upon these foundations by integrating advanced Industry 4.0 technologies—such as artificial intelligence, the Internet of Things, cloud computing, and real-time analytics—into quality systems, fostering intelligent, agile, and data-driven decision-making. This study presents a comprehensive review of the Quality 4.0 paradigm, exploring its conceptual foundations, enabling technologies, practical applications, and implementation challenges. A gap analysis highlights key limitations in traditional quality practices, including fragmented digital infrastructures, underutilized data, limited adaptability, and inadequate human–machine collaboration. To address these challenges, a strategic Quality 4.0 framework is proposed, combining classical quality principles with digital tools and Lean Six Sigma methodologies to drive continuous improvement, enhance customer value, and optimize performance within interconnected environments. The framework defines strategic objectives and key performance indicators to support implementation, monitor progress, and enable continuous refinement, while also addressing critical enablers such as system integration, workforce development, data governance, and cybersecurity. Ultimately, the study positions Quality 4.0 as a transformative subset of Industry 4.0, shifting quality management from a reactive mindset to a proactive, predictive, and sustainable digital excellence, and outlines future research directions to support its sustainable advancement.