Problem & Purpose: In the perioperative department of a small community hospital 15% of pediatric surgical patients experienced postoperative sore throat, stridor, and laryngospasm with two requiring transfer to tertiary facilities. Root cause analysis revealed that anesthesia providers used subjective endotracheal tube cuff pressure assessment rather than objective technique, representing a gap in practice likely contributing to airway complications. This quality improvement project aimed to implement an evidence-based practice change by integrating manometers for objective cuff pressure measurement, ensure a safe pressure range of 20-30 cmH₂O, and reduce postoperative sore throat, stridor, and laryngospasm in intubated pediatric surgical patients. Methods: After literature review and mobilization of a multidisciplinary team including the clinical site representative, chief anesthesiologist, assistant director, director of perioperative services, and anesthesia technician, the project was implemented over 15 weeks in Fall 2024. Seven of eight anesthesia providers received education on manometer use and documentation requirements. Manometers were placed in two pediatric airway carts and visual reminders posted in operating rooms. Weekly chart audits and observations tracked adherence and outcomes in 72 patients. Results: Provider adherence was 61.1%. Cuff pressures were documented within safe range in 88.6% of cases. Negative outcomes occurred in 2.8% of patients, one sore throat in week 1 and one laryngospasm in week 10, representing a significant reduction from baseline. Conclusion: Findings align with existing literature and support the feasibility of integrating manometers into routine practice. Maintaining endotracheal tube cuff pressures within a safe range of 20-30 cmH₂O effectively reduces postoperative sore throat, laryngospasm, and stridor in the pediatric surgical patient.