Pediatric patients (younger than 19 years) account for approximately 25% of all emergency patients. Pediatric patients have large proportions of toddlers (aged 1-5 years), low severity, illness (rather than injury), and after-hours visits. Considering these features, the authors, affiliated with the policy research team in the Korean Society of Pediatric Emergency Medicine, suggest the establishment of the pediatric certified emergency center (PCEC) to stratify Korean pediatric emergency medical system according to the Korean Acuity and Triage Scale (KTAS). The PCEC is a facility dedicated to the emergency care for a large population of KTAS 3-4 patients (i.e., mildly ill). In addition, the PCEC may perform early stabilization and transfer to the pediatric emergency centers for pediatric patients having KTAS 1-2 illnesses and injuries. To facilitate the application of emergency centers for the PCEC, the designation criteria should be flexible in terms of manpower, facility, and equipment. Financial support from the government is essential for sustainable PCEC.