We show that a quasi-symmetric design with intersection numbers 1 and y > 1 and a good block belongs to one of three types: (a) it has the same parameters as PG2(4, q), the design of points and planes in projective 4-space; (b) it is the 2-(23, 7, 21) Witt design; (c) its parameters may be written v = 1 + ((α − 1)λ + 1)(y − 1) and k = 1 + α(y − 1), where α is an integer and α > y ≥ 5, and the design induced on a good block is a 2-(k, y, 1) design. No design of type (c) is known; moreover, for large ranges of the parameters, it cannot exist for arithmetic reasons concerning the parameters. We show also that PG2(4, q) is the only design of type (a) in which all blocks are good.