Background <p>Point-of-care ultrasound is an evolving field in medical education and emergency practice. Numerous pieces of evidence support the use of point-of-care ultrasound in children to improve outcomes. Pediatrics as a specialty has been relatively late to adopt point-of-care ultrasound, with a significant gap in specific recommendations and implementation. Assessing pediatric residents’ perception and knowledge is one of the crucial factors for successfully integrating point-of-care ultrasound into pediatric emergency and critical care practice. The objective of the study is to describe pediatric residents’ perception toward pediatric point-of-care ultrasound practice and identify factors associated with knowledge of point-of-care ultrasound.</p> Method <p>A cross-sectional study assessed the perception and knowledge of 97 pediatric residents from Year 1 to Year 3 in two tertiary hospitals in Addis Ababa. An online questionnaire was used to collect data on demographics, perception, and knowledge toward point-of-care ultrasound. The data was entered and analyzed using SPSS version 26 software, employing analytic and descriptive parameters. Binary and multivariable logistic regression analyses were conducted to identify factors associated with point-of-care ultrasound knowledge.</p> Result <p>A majority (70.1%) of residents have a good understanding of the potential use of point-of-care ultrasound for pediatrics. A majority (67%) of residents rated point-of-care ultrasound as a valuable tool for improving diagnostic accuracy with a Good perception. Regarding the importance of integrating point-of-care ultrasound training into pediatric residency programs, 70.1% of residents have a positive perception. The most significant perceived barrier to point-of-care ultrasound practice is a lack of training (72.2%). Residents with any form of point-of-care ultrasound training were significantly more likely to score above the median knowledge assessment (AOR = 58.46; 95% CI: 5.835-585.858; P-value = 0.01). Residents who reported using point-of-care ultrasound once a month or once a week were significantly more likely to have good knowledge of point-of-care ultrasound compared to those who never or rarely used it (AOR = 9.000; 95% CI: 2.307–35.118; P-value = 0.020 and AOR = 7.661; 95% CI: 1.375–42.695; P-value = 0.039), respectively.</p> Conclusion and recommendation <p>Our findings reflect a positive self-perception among pediatric residents toward integrating POCUS into residency training. This integration is likely to increase acceptance among pediatric residents. Our results highlight the importance of prior training and regular use of point-of-care ultrasound in enhancing the knowledge of pediatric residents. We recommend that further studies be conducted to assess the impact of educational interventions on the pre- and post-knowledge of pediatric residents toward point-of-care ultrasound. Another area of interest for future research would be the factors hindering the integration of point-of-care ultrasound into pediatric curricula.</p>