This commentary discusses the increasing recognition of diagnostic errors, the limited research to understand and prevent them, and an approach from aviation that may further those efforts. The authors begin with a general discussion about diagnostic errors before presenting a framework for situational awareness—a model developed in aviation that focuses on decision making. Using a case example, the authors illustrate how situational awareness can be applied to health care settings by asking fundamental questions that incorporate a cognitive approach with a systems approach. They advocate for greater study of this approach in patient care, realizing that many of the advantages are also met with limitations in translating it from aviation. A past study evaluated 100 cases of diagnostic error to similarly describe the contributions of system-related problems versus cognitive ones.