ACS verification is the highest standard of excellence from trauma centers in the United States. In simplest terms, it involves rigorous demonstration that the trauma program has the people, processes, resources, and quality needed to care for injured patients. Trauma center standards are derived from the Resources for Optimal Care of the Injured Patient. Verification requires trauma infrastructure (staffing, equipment, facilities, documentation, processes of care), strong performance improvement and patient safety (PIPS) program, accurate and timely trauma registry data and chart abstraction, extensive policies and guidelines to drive care, commitment to education and injury prevention in the outlying community, and (for Level I trauma centers) commitment to medical education (general surgery residency) and scholarly research.