In 2015, the American Academy of Pediatrics (AAP) published a policy statement on point-of-care ultrasound (POCUS) use in the pediatric emergency department (PED). This highlighted the responsibility of pediatric emergency medicine (PEM) physicians to evolve with POCUS to provide safer and more efficient care to pediatric patients. Robust quality assurance (QA) mechanisms are necessary in the PED. We present 4 cases where timely QA led to crucial management adjustments and appropriate follow-up imaging. A POCUS QA process with image review for all performed studies is essential to build partnerships across subspecialties and to mitigate misinterpretation that could harm patients.