There is a very slight difference between hand quilted and machine quilted. You can't see it with your eyes, it's not a visual difference. When you give your quilt away and it's machined quilted has the recipient ever said "Gee, I wish you had hand quilted this". Not likely! I think the difference is will it be used or sit on a shelf. Don't get me wrong, I love both. I can't picture me committing the time to hand quilting. I so admire the people who can. I love machine pieced and/or quilted. I can see myself making a machined quilt. The only difference to me is time and usage. As I said, I love hand pieced and hand quilted quilts, but I'd never use one. I might hang it up for all to see, but would never put it on a bed. I'd be terrified that something would get stained or ripped and the person who gave it to me would be offended. I don't feel quite the same way about machine-pieced and machine-quilted quilts. I love them because I think they are made to be used and the person who gave it to me would be horribly offended if I didn't use it. There are quilts in both categories that I would hang and never place on a bed. But to me a hand quilted piece is made to show but not necessarily to be used. And a machined quilt is made to used and/or displayed. I think the only difference is.....Now that I think about it there is no real difference, not even slightly...LOL!