The Intersocietal Accreditation Commission (IAC) is a non-profit accrediting organization committed to ensuring the quality of diagnostic imaging and related procedures. It is comprised of a collaboration of stakeholders, spanning numerous medical professionals and specialties. In a recent initiative, IAC Echocardiography introduced a new accreditation specifically for Perioperative Transesophageal Echocardiography (PTE). This accreditation process is anchored in rigorous clinical peer review to ensure diagnostic quality and report accuracy, thus maintaining high standards of medical care.The authors represent the inaugural four sites to achieve IAC accreditation for PTE who have collaborated to share their experiences in achieving this accreditation. This review endeavors to offer actionable insights and proven solutions to navigate the accreditation journey for others. Mirroring the IAC Standards and Guidelines for PTE accreditation, this review is divided into three pivotal sections: 1) organization of a perioperative echocardiography service, including stakeholder engagement to facilitate the application for accreditation; 2) performance of examinations and reporting; and 3) instituting quality improvement strategies and establishing a robust program.The pursuit of accreditation in PTE is to transcend a mere compliance exercise. It signifies a dedication to excellence, continual growth, and above all to the well-being of patients.