Gastrostomy tube (GT) placement is a common surgical procedure performed in the pediatric patient population to ensure delivery of enteral nutrition to patients with congenital gastrointestinal disease or at high risk of aspiration. GTs, however, are associated with frequent complications and are a commonly seen presentation in the pediatric emergency department (PED). Traditionally, GT replacements are performed by the trained pediatric emergency medicine physician, followed by a fluoroscopic confirmation. Existing literature shows that GT complications occur at such a high rate that frequent replacements and radiographic confirmations will increase the pediatric patient’s life-time radiation exposure. We present a case of a pediatric patient presenting to the PED for GT replacement. Through the use of point-of-care ultrasound (POCUS), GT placement was confirmed without complications or use of radiographic imaging. The aim of our report is to demonstrate both the utility and advantages of using POCUS to confirm GT replacement in the PED.