The literature suggests that pediatricians in the United States are concentrated in the more densely populated regions and states, whereas family physicians and general practitioners are more likely to settle in rural areas. The rapidly increasing supply of all child health physicians had led many to hypothesize that the traditional geographic preferences of pediatricians would expand to include smaller communities. Data for 1976 to 1979 confirm the urban concentration of pediatricians and the more even distribution of family physicians and general practitioners. These data also demonstrate a marked imbalance of pediatricians within county groups, resulting in some areas of shortage even within highly metropolitan communities. Evidence of a trend toward increased dispersion of pediatricians into urban shortage areas is presented, but there is no indication that enough pediatricians will settle in rural areas to meet the needs of children in those small communities.