The trust was inspected on a large range of factors
A North Yorkshire NHS Trust has received the highest mark possible for the second year running in the annual healthcare ratings.
Harrogate and District NHS Foundation Trust has been rated "excellent" for both its quality of services and financial management.
Chief executive Richard Ord said: "It is a fantastic achievement."
York Hospitals NHS Foundation Trust has dropped from "excellent" to "good " for quality of services.
Meanwhile Scarborough and North East Yorkshire Healthcare NHS Trust improved in both categories from "weak" to "fair" as has North Yorkshire and York Primary Care Trust.
Harrogate is among four of 15 trusts in Yorkshire and the Humber to have achieved the highest overall rating of excellent by the Care Quality Commission (CQC).
Nationally, 37 of the 169 acute and specialist trusts have achieved this rating.
Mr Ord said: "Excellent healthcare is not just about how an operation goes. It is about treating our patients with dignity, listening to their comments, learning when things go wrong and valuing our staff so they are as highly motivated as possible to deliver that excellent care."
It is the fourth year the CQC has carried out its annual assessment of the NHS.
It is based on the trusts' performance between 1 April 2008 and 31 March 2009 and rates each organisation as excellent, good, fair or weak on both its quality of services and financial management.
The inspection measures trusts' compliance over a large range of factors, from the number of MRSA infections to waiting times and how well it listens to patients' comments.