OBJECTIVE: This narrative review provides an overview of the use of ultrasound in pediatric intensive care. It investigates point-of-care ultrasound (POCUS), which is a goal-directed approach for rapid clinical decision making and provides a multiorgan approach for assessment of complex disease states. This review is organized by integrating point-of-care ultrasonography for pediatric intensive care into the A-Airway, B-Breathing, C-Circulation, D-Disability resuscitation sequence in the primary assessment of critically ill patients after the paragon of the ABCD curriculum by Lichtenstein et al. ----- METHODS: Data is collected by literature research on Pubmed and referencing literature of found articles. Educational literature is taken from chapters in edited books. Point-of-care ultrasound represents an extensively used tool by different fields, therefore taken literature spans various specialities including emergency medicine, anaesthesiology, intensive care, pediatrics, and cardiology. ----- DISCUSSION: Point-of-care ultrasound in pediatric critical care is an emerging field and further studies are required. In relation to the ABCD assessment, research needs to be conducted for POCUS in pediatric patients with congenital malformations and patients after cardiac surgery. Different protocols and approaches for the same clinical presentation need to be compared in order to define a standard. Assessment of inferior vena cava is still controversial and requires a standard. ----- CONCLUSION: Point-of-care ultrasound in pediatric intensive care is the leading method for accurate assessment and timely intervention. It enhances decision-making, management and intervention as an extension of traditional physical examination. Due to its established use in clinical practice and its development potentials, it should be integrated into medical school curriculum.