Quality Score is a metric Google uses to determine your page ranking and how much you pay per click in a particular Google AdWords campaign.
Quality Scores are essentially a measure of relevance; more relevant ads, campaigns, and landing pages have higher clickthrough rates (CTRs), which raises your Quality Score.
Google ranks Quality Score on a scale of 1-10 (with 10 being the best). Higher Quality Scores tend to lead to lower costs-per-click (CPC), which translate into lower costs per conversion.
In other words, optimizing for Quality Score also helps you optimize for costs and ROI.

Originally published Apr 19, 2014 8:00:00 AM, updated October 30 2019
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