While Six Sigma is increasingly implemented in industry, little academic research has been done on Six Sigma and its influence on quality management theory and application. There is a criticism that Six Sigma simply puts traditional quality management practices in a new package. To investigate this issue and the role of Six Sigma in quality management, this study reviewed both the traditional quality management and Six Sigma literatures and identified three new practices that are critical for implementing Six Sigma's concept and method in an organization. These practices are referred to as: Six Sigma role structure, Six Sigma structured improvement procedure, and Six Sigma focus on metrics. A research model and survey instrument were developed to investigate how these Six Sigma practices integrate with seven traditional quality management practices to affect quality performance and business performance. Test results based on a sample of 226 US manufacturing plants revealed that the three Six Sigma practices are distinct practices from traditional quality management practices, and that they complement the traditional quality management practices in improving performance. The implications of the findings for researchers and practitioners are discussed and further research directions are offered.