Purpose of Review <p>Pediatric urologists practice in a variety of settings, including freestanding children’s hospitals, pediatric hospitals within adult hospitals, and satellite campuses. Each of these types of practice carries advantages and disadvantages that may impact patient care. This article reviews the current literature to evaluate the strengths and weaknesses of various practice types and their potential effect on patient outcomes.</p> Recent Findings <p>Current literature demonstrates the majority of pediatric operations are performed at institutions with a freestanding children’s hospital or within a pediatric unit at an adult hospital and suggests cases performed outside of these pediatric-specific settings may have inferior outcomes. However, tertiary care hospitals and pediatric subspecialty care is regionalized in urban areas resulting in limited access to rural populations.</p> Summary <p>Free-standing children’s hospitals offer highly specialized, multidisciplinary pediatric care, while pediatric hospitals within adult hospitals may have unique access to advanced technology through adult services. Satellite clinics play a distinct role in improving access to subspecialty care for rural populations.</p>