The purpose of this study was to examine student perceptions of quality and satisfaction in regionally accredited online courses. This study intended to answer the following four research questions (1) Is there a significant difference in levels of student satisfaction between online courses that have undergone a systematic faculty peer review process and online courses that have not undergone a systematic faculty peer review process?; (2) Is there a significant difference in levels of student satisfaction between online courses that have not undergone a systematic faculty peer review process but are affiliated with a peer review program and online courses that have no affiliation with a peer review program?; (3) Which factors of quality instruction most directly relate to increased levels of student satisfaction in online courses that have been faculty peer reviewed?; and (4) Which factors of quality instruction most directly relate to increased levels of student satisfaction in online courses that have not been faculty peer reviewed but are affiliated with a peer review program? A total of 157 responses (out of 1,774 solicited) were obtained from the student satisfaction questionnaire, which is a 9% student response rate. A total of 7 responses (out of 54 solicited) were obtained from the course designer questionnaire, which is a 13% course designer response rate. Results of the study confirmed with statistical significance that students who were more comfortable with distance learning reported higher satisfaction with their online course. Results of the study also indicated that online courses that have undergone a formal peer review may lead to higher student satisfaction in the course. Surprisingly, however, results also indicated that courses that have not undergone a formal peer review but that are offered at institutions that are subscribed to a peer review program may lead to lower student satisfaction of the course. Both of these results were non-significant. The researcher recommends striving for statistical significance in future research by using a larger sample size. Additionally, the researcher recommends future research regarding the correlation of student satisfaction to peer review subscriptions, even without a formal peer review.