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The purpose of this editorial is to introduce the ethical considerations surrounding pediatric orthopaedic global outreach and stimulate discussion about how to best approach this work. Bidirectional exchange with partner surgeons in low- and middle-income countries forms the foundation of successful outreach. Fostering these relationships and approaching outreach with humility and curiosity allows for a genuine needs assessment. The outreach program can then be designed to address the needs of the target community. Success should not only be defined as the number of surgeries performed, but also the number of healthcare workers trained and sustainable programs created at the host site. Remember that nurses, physical therapists, and surgical technologists also desire training. Finally, it is important to understand and identify any implicit or explicit bias before pursuing global outreach as that may hinder successful outcomes and bidirectional exchange with host surgeons.