As in other European countries, Belgian hospitals encounter difficulties in recruiting paediatricians. The task of a paediatrician in the hospital is more diversified than in other specialties. The Belgian Academy of Paediatrics performed a survey in 2007 in order to assess the demographic characteristics and the workload of the hospital paediatricians in Belgium. There is an ongoing feminization among hospital paediatricians. No gender difference could be observed in the time spent in the various types of paediatric medical activity in the hospital. Male paediatricians spend however more than two half-days in clinical activities outside the hospital. Ambulatory care remains important as well in regional as in university paediatric departments. Non-curative tasks form about one third of the working time. The number of days on-call per paediatrician is higher in regional vs university hospitals. The mean size of paediatric regional hospital teams in Flanders is smaller than in French-speaking Belgium (4 vs 8), resulting in a higher on-call activity per paediatrician. In 2007, about 100 vacancies were reported by the heads of the paediatrics department, in three out of four hospitals.