Laboratory analysis involves three main phases: pre-analytical, analytical and post analytical. For a long time, analytical and post-analytical phases were deemed important in medical biology. However, in the last few years, there is growing awareness about pre analytical aspects and issues making it the new major challenge in medical laboratory. Pre analytical phase encompasses a large range of variables that are associated with patient characteristics, sample collection and sample processing. Pre analytical phase is of paramount importance in medical diagnostics, but it continues to be underestimated in research and clinical trials. A paradigm shift in the quality management of pre analytical phase is overdue, especially with the increase of clinical omics application such as metabolomics.