Advances in technology, the evolution of patient- and-family centered care, and infection control challenges—evidenced during the COVID-19 pandemic—highlight the possibilities and challenges of intensive care unit (ICU) design. For example, prior ICU design guidelines in 1995 and 2012 did not envision remote manipulation of ventilator settings or infusion pumps, or the unique problems presented by pandemic care. As a result, the Society of Critical Care Medicine (SCCM) sought to update the 2012 ICU design guidelines. Published in Critical Care Medicine, the journal of SCCM, these new guidelines provide evidence-based recommendations for clinicians, administrators, and healthcare architects to optimize design strategies in new or renovation projects.