As ultrasound is increasingly prevalent in critical care medicine, there is need for systematic development of programs for training, credentialing, and competency. In this chapter, we describe the required infrastructure for these programs, including personnel, equipment, image archival, and integration with other institutional structures. Education consists not only of medical and ultrasound knowledge but also of image acquisition and interpretation skills. At present, there is no certification for critical care ultrasound, although a certification pathway exists for critical care echocardiography. Credentialing and maintenance vary by institution, although they share common themes of didactic and practical education and upkeep and minimum numbers of examinations.