The aim of this paper is to review the microbiological quality of food samples taken from a wide range of cooked and raw foods obtained from restaurants and sweet shops in the Ramallah and al-Bireh district, and to identify the gaps in food inspection and handling that can be realistically improved. Utilizing food sample test results of the Palestinian Ministry of Health, records pertaining to the years 1995, 1996, 2000, 2002, and the first 2 months of the year 2003 reveal that only 60.9%, 44.0%, 63.8%, 93.6%, 51.8%, 83.8%, and 50.4% of the food samples tested for total aerobic count, total Coliform, faecal Coliform, Staphylococcus aureus, faecal Streptococci, moulds, and yeasts respectively are within the limits of the Palestinian and International standards. None of the tested samples for Salmonellae or Clostridium perfringes were positive. Analysis of the data indicates an irregular rather than systematic process to testing. For example, 60.4% of the tested food samples in 2000 came from sweet shops, while the relative percentage of sweet shops is 21.4% out of the total restaurants and sweet shop figures in the area at the time. In contrast to what would be expected, most of the samples were collected during the cold season, raising questions as to the suitability of testing procedures and guidelines. Systemic and procedural gaps were identified by the analysis that can be addressed to at least contain, if not completely eliminate the presence of foods in the market that are unacceptable for consumption.