Acute kidney injury (AKI) in children is associated with increased mortality and morbidity including the need for prolonged stay in pediatric intensive care unit (PICU) and longer duration of mechanical ventilation. Technological advancements have expanded the array of bedside tools available to clinicians for patient evaluation beyond the traditional physical examination. Point-of-care ultrasound (POCUS) has emerged as a crucial tool for clinicians to quickly diagnose kidney pathology and assess the volume status. This is especially useful in the PICU setting as clinicians seek to optimize fluid requirements, modify dialysis settings based on fluid overload status, and differentiate causes of shock. Herein, we review the role of POCUS focusing on management of critically ill children with AKI, and the improvements in technology and artificial intelligence (AI) in POCUS that allow for better outcomes.