Critical care ultrasound (CCUS) is a tool enabling providers to deliver bedside care to the sickest patients in the hospital. Competency in CCUS involves understanding its indications, acquiring and interpreting images, and integrating this information for clinical decision-making. Core examinations include focused transthoracic echo (basic and/or advanced), thoracic ultrasound, abdominal ultrasound, vascular diagnostic, and procedural guidance. Certification, provided by an external professional society or certifying body, and credentialing, conducted internally by an individual provider’s health care organization, are both processes designed to ensure competency. This article clearly defines these concepts, reviews relevant literature, and offers guidance on best practices.