To manage type 1 diabetes (T1D), it is essential to regularly monitor blood glucose levels and ketones. Since the advent of continuous glucose monitoring (CGM), fingerstick blood glucose monitoring (BGM) has become the standard of care, even though fingerstick BGM has been the standard of care for decades. A review is provided here of recommendations for self-monitoring glucose and ketones in pediatric T1D, with particular emphasis on continuous glucose monitors (CGMs) and factors that affect their accuracy.