Bespoke or Made to Measure?

This is still a mystery to those who don't regularly purchase suits.  In fact, even with those that do.  It's all about expectations.
Made to Measure sounds as though you'll receive a perfectly fitting suit, and in some cases you do.  I'll explain.  Made to Measure (or Personal Tailoring) is a step up from Ready to Wear tailoring, in which a few minor alterations can be made.  If you're looking at anything more than adjusting lengths or widths then the next stage up is Made to Measure.
Using a pre existing pattern you are put in the nearest size that fits you, then your consultant can be a little more precise with adjusting that pattern to suit your own body shape and needs.  Made to Measure will always fit better than Ready to Wear and you also have the option of choosing from a set of options -  cloth, style and the detailing which makes your chosen suit individual to you.
How well your Made to Measure suit fits depends a lot on the experience and eye for detail your consultant has.  But remember, the Made to Measure consultant is not a tailor, he/she is a salesperson who has a specialised knowledge of suit fitting and construction.

Bespoke is the top of the tree when it comes to tailoring.  Instead of a pre existing pattern, a cutter will measure and cut a unique pattern just for you.  The cutter will have years of experience judging body shapes and knowing how to create a suit that that will fit you perfectly.  If you are a particularly awkward shape to fit and you want a suit that fits you well, then in a lot of cases Bespoke will be your only option.  As instead of trying to adjust a pattern to to fit you, the pattern will be cut to fit you in the first place.  All cutters are I've met are perfectionists and will strive to deliver something both they and the customer will be proud of.  It does nobody any favours to be looking like a bag of shit with a label reminding everyone who is responsible.

With Bespoke you can really get creative, as you're not limited to your choice of style and detailing, but hopefully your cutter can reign you in if you have any awful ideas or bad taste.
Obviously there's a big price difference, so we can't all afford to have all our suits Bespoke, but it's worth saving up for at least one at some point.  As with tailoring you get what you pay for.  So have a budget and go a little over that to get a suit you can be proud of.  Suits you sir!