- Introduction: In the coming years a worldwide physician shortage is expected. However, little is known regarding pediatrician workforce planning worldwide. The main factors influencing the shortage of physicians include a long and expensive training, physicians’ migration, changing career patterns, early retirement, gender and novel technologies. In this ecological descriptive study we studied past (1995-2006) and future (through 2025) pediatrician workforce trends in Israel. We compared the Israeli pediatrician workforce to other countries. Main outcome: ratio of pediatricians < 65 years-of-age per 1,000 children. Results: The recommended ratio of pediatricians in the USA per 1,000 children grew by more than 50% from 1990 (0.49) to 2000 (0.77). In 2006, the average ratio of pediatricians in Israel per 1,000 children was 10% less than that recommended in the USA. Average ratio of pediatricians per 1,000 children in 77 countries is half (0.38) of the recommended ratio in USA, year 2000. Conclusion: Lack of system outcomes measures, in addition to differences, between countries of about 100%, regarding the required ratios of pediatricians/per 1,000 children provides us with an evidence that one parameter cannot forecast an efficient pediatric workforce. Since planning is a very complex task, decision makers in different health care systems need more indices to plan a cost effective pediatric workforce.