This paper describes two comparative studies of voice quality assessment based on complementary approaches. The first study was undertaken on 449 speakers (including 391 dys-phonic patients) whose voice quality was evaluated in parallel by a perceptual judgment and objective measurements on acoustic and aerodynamic data. Results showed that a non-linear combination of 7 parameters allowed the classification of 82% voice samples in the same grade as the jury. The second study relates to the adaptation of Automatic Speaker Recognition (ASR) techniques to pathological voice assessment. The system designed for this particular task relies on a GMM based approach, which is the state-of-the-art for ASR. Experiments conducted on 80 female voices provide promising results, underlining the interest of such an approach. We benefit from the multiplicity of theses techniques to evaluate the methodological situation which points fundamental differences between these complementary approaches (bottom-up vs. top-down, global vs. analytic). We also discuss some theoretical aspects about relationship between acoustic measurement and perceptual mechanisms which are often forgotten in the performance race.