Hydrophones are pivotal measurement devices ensuring medical ultrasound acoustic exposures comply with the relevant national and international safety criteria. These devices have enabled the spatial and temporal distribution of key safety parameters to be determined in an objective and standardized way. Generally based on piezoelectric principles of operation, to convert generated voltage waveforms to acoustic pressure, they require calibration in terms of receive sensitivity, expressed in units of [Formula: see text]Pa-1. Reliable hydrophone calibration with associated uncertainties plays a key role in underpinning a measurement framework that ensures exposure measurements are comparable and traceable to internationally agreed units, irrespective of where they are carried out globally. For well over three decades, the U.K. National Physical Laboratory (NPL) has provided calibrations to the user community covering the frequency range 0.1-60 MHz, traceable to a primary realization of the acoustic pascal through optical interferometry. Typical uncertainties for sensitivity are 6%-22% (for a coverage factor k = 2), degrading with frequency. The article specifically focuses on the dissemination of the acoustic pascal through NPL's calibration services that are based on a comparison with secondary standard hydrophones previously calibrated using the NPL primary standard. The work demonstrates the stability of the employed dissemination protocols by presenting representative calibration histories on a selection of commercially available hydrophones. Results reaffirm the guidance provided within international standards for regular calibration of a hydrophone in order to underpin measurement confidence. The process by which internationally agreed realizations of the acoustic pascal are compared and validated through key comparisons (KCs) is also described.