Purpose of Review Communities occupy a central position in effective health systems, notably through monitoring of health service quality and by giving recipients of care a voice. Our review identifies community-led monitoring mechanisms and best practices. Recent Findings Implementation of community-led monitoring mechanisms improved service delivery at facility-level, health system-wide infrastructure and health outcomes among recipients of care. Successful models were community-led, collaborative, continuous and systematic, and incorporated advocacy and community education. Summary Identifying and replicating successful community-led monitoring practices is a key pathway to equitable access to HIV and health services overall.