Despite efforts for greater patient engagement in health care quality improvement, evaluation practice in this context remains mostly conventional and noncollaborative. Following an explication of this problem we discuss relevant theory and research on patient-centred care (PCC) and patient engagement and then consider potential benefits of collaborative and participatory approaches to evaluation of such initiatives. We argue that collaborative approaches to evaluation (CAE) are logically well-suited to the evaluation of PCC initiatives and then suggest contributions that the evaluation community can offer to help advance patient engagement. Finally, we outline a research agenda that identifies important areas that are in need of further examination.