The PCAOB inspects smaller CPA firms every three years to see how well they are doing their audits. Smaller firms felt the inspections had a negative impact on their audit practices, while medium and larger firms had more positive outcomes. Overall, firms thought the inspection team did a good job, but had issues with other parts of the process. Satisfaction with inspections increased with firm size and over time. The study suggests that focusing on unintended consequences and making changes to the inspection process could make PCAOB inspections more effective.