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Objective To assess the current distribution and training patterns of pediatric nurse practitioners (PNPs). Study design Secondary data analysis from the National Association of Pediatric Nurse Practitioners and the 2008 US Census Bureau were used to estimate the distribution of PNPs per 100 000 children. Data on nurse practitioner (NP) graduation and specialty education programs were obtained from the American Association of Colleges of Nursing. Results PNPs have the greatest concentration in the New England and mid-Atlantic regions and a narrow band of Midwestern states. States that allow PNPs to practice or prescribe independently do not consistently have a higher density of PNPs per child population. There has been a slight decrease in the proportion of programs that offer PNP training. In the last decade, the proportion of NP graduates pursuing family nurse practitioner education has increased, and the proportion pursuing PNP education has decreased. Conclusion Workforce planning for the health care of children will require improved methods of assessment of the role of PNPs and the volume of care they provide. Increased use of PNPs in pediatrics will likely require greater effort at recruitment of NPs into the PNP specialty.