Mutation testing helps improve test quality by automatically generating small source code changes, called mutations, and determining whether tests can detect, or kill, those mutations. While unit tests may achieve high code coverage, mutation testing helps identify weaknesses by ensuring tests fail when source code is changed. It works by finding mutations in code, like changing conditionals from AND to OR, covering affected cases to kill mutants, and calculating a mutation score based on the number of mutants killed over the total. Mutation testing tools can help automate the process of finding and running mutants on a package or class without running all tests on the full codebase each time.