The objective of this short communication was to evaluate the roles of reputation and objective measures in U.S. News rankings of the top 50 children's hospitals for diabetes and endocrinology. Analysis was performed on data obtained from the 2011 to 2012 report. Reputation scores exhibited more variance (CV = 158%) compared to objective measures (average CV = 14%). Ranking hospitals based on reputation, compared to total score, identified the same top hospital, same top five hospitals, and 90% of the same top 10 hospitals. Ranking based on total objective score resulted in different top hospitals, 60% of the same top five hospitals, and 50% of the same top 10 hospitals. Hospital total rank was strongly associated with reputation rank (rho2 = 0.78) and moderately associated with objective rank (rho2 = 0.48). Objective rank was minimally associated with reputation rank (rho2 = 0.19). Among the top 50 children's hospitals in diabetes and endocrinology, standings reflect reputation more than objective measures.