The electronic health record (EHR) is a key component in the delivery of healthcare in most hospitals in the USA today. Current EHR systems have evolved from simple databases for basic administrative and patient information to complex systems that are also capable of storing clinical documentation, laboratory results, and radiologic images, as well as transmitting patient care orders throughout a hospital's various departments and systems. Within the EHR, clinical decision support (CDS) tools have the potential to help improve patient care by standardizing practice, reducing errors, and aiding diagnostic and therapeutic decision-making. In the pediatric hospital setting, CDS tools can deliver pediatricspecific information and guidance on disease management through alerts, computerized provider order entry and order sets, and clinical practice guidelines. These various CDS functions are of great importance to the practice of safe, high-quality patient care and learning to maximize their potential is of great benefit to clinicians. At the same time, these tools must be implemented in a manner consistent with established CDS best practices to prevent potential unintended consequences that introduce new sources of error and potential harm.