Aim: Sometimes treatment is not necessarily according to guidelines, which is partly due to attitudes rather than lack of knowledge. In Germany, regional differences concerning prevalence rates of ADHD exist without valid explanation. We contribute with our data to the question of attitudes toward ADHD among pediatricians in Germany., Method: A specially designed questionnaire based on the Knowledge of Attention Deficit Disorders Scale and previous surveys was sent to pediatricians. In addition to descriptive statistics, we performed factor analysis and multiple linear regression analysis., Results: The vast majority (85.5%) of 581 respondents have a positive attitude toward ADHD, i.e., ADHD exists and should be treated appropriately. Physicians with positive attitudes were older and more often had a neuropediatric specialization., Conclusion: Most of the pediatricians surveyed in Germany assess ADHD and treatment in line with medical guidelines and treat as part of multimodal therapy., Supplementary Information: The online version contains supplementary material available at 10.1007/s10389-022-01758-4., Competing Interests: Conflicts of interestMarie E. Fechner, Yuliya Mazheika, Folkert Fehr & Ronny Jung have no conflicts of interest or financial ties to disclose. Peter Borusiak received support in the last five years from, has served as a speaker for and participated in investigations of InfectoPharm (Germany) and Central Krankenversicherung (Germany). He received grants from the Else Kröner-Fresenius Foundation, Witten/Herdecke University, Märtens-Foundation and Bundeszentrale für gesundheitliche Aufklärung (all Germany)., (© The Author(s) 2022.)