Sick neonates in non-tertiary centers rely on the expert skills of neonatal transport teams (NTTs) and efficient systems to provide safe and timely transport to tertiary centers. Quality metrics to measure and compare performance among transport teams are essential to ensure delivery of high-quality care and efficient use of limited and costly resources. We review the most relevant quality metrics available in neonatal transport and key issues to consider during their utilization. The use of quality metrics for quality improvement is described through the experience of a neonatal transport program based at a quaternary children's hospital in Canada.