This review summarizes the literature on safety walkrounds, which broadly involve health care executives or senior managers visiting frontline staff and engaging in conversations about potential safety issues. Following evidence that walkrounds improved safety culture, this practice became widely endorsed by AHRQ and other leading health care organizations. However, this review includes a number of cautionary notes about the limitations of safety rounds and prior research on the efficacy of these programs. The authors outline evidence-based keys to successful implementation, highlighting that failure to follow up on concerns raised may actually erode, rather than enhance, safety culture. A past AHRQ WebM&M perspective by Dr. John Wittington stressed the importance of involving hospital leadership in quality and safety efforts.