When is Every Quasi-Multiplier a Multiplier?

We answer the title question for sigma-unital C*-algebras. The answer is that the algebra must be the direct sum of a dual C*-algebra and a C*-algebra satisfying a certain local unitality condition. We also discuss similar problems in the context of Hilbert C*-bimodules and imprimitivity bimodules and in the context of centralizers of Pedersen's ideal.