This article describes the evolution of board certification for pediatricians and the current ongoing assessment process called Maintenance of Certification (MOC). To be called a board-certified pediatrician under the MOC framework requires a level of training, competence, and knowledge that can only be achieved by completing a rigorous, defined, closely monitored training program approved by the Accreditation Council for Graduate Medical Education and then demonstrating a level of knowledge comparable to established standards by passing the initial certifying examination. Once this landmark baseline threshold is reached, the emphasis shifts to demonstrating lifelong professional development and the ability to deliver quality care and to continually improving that care through MOC.