Poplars Medical Practice in Low Hill was rated by Care Quality Commission (CQC) inspectors who looked at how safe, effective and well-led it was.
They inspected 45 GP surgeries across England.
Two were rated as outstanding, in Gerrards Cross, Buckinghamshire, and Oldham.
Inspectors said staff at the Hall Practice, Gerrards Cross routinely referred to national health guidelines, received appropriate training and GPs' special interests and expertise were utilised.
In Oldham, patients at Hope Citadel Healthcare rated the practice higher than others for almost all aspects of care, inspectors reported.
Five others surgeries required improvements, inspectors found.
The Low Hill surgery served more than 3,200 patients in one of the most deprived areas in the UK, the CQC said.
Inspectors found systems to manage and address risks were not properly implemented, knowledge of and reference to national guidelines was inconsistent and there were no completed audits of patient outcomes.
It was rated good in a category for caring but inspectors said it required improvement for providing responsive services.
A CQC spokesman said further measures may be taken if sufficient improvement was not visible in the coming months.
Prof Steve Field, chief inspector of general practice, said the vast majority of England's GPs provided a safe, effective, caring, responsive and well-led service.
"Patients should be able to expect high-quality and consistent care from every GP practice," he said.
"Where we have required improvement, we will expect the practice to take the necessary steps to address the issue, and we will return at a later date to check that those improvements have been made."
Practices put it into special measures got more support from NHS England to help them improve, he said.
A GP surgery in Wolverhampton has been put into special measures after being rated inadequate by a healthcare watchdog.