Background <p>Mental health disorders significantly affect children’s development and contribute to a substantial global burden, increasing demand for mental health care within primary pediatric settings. This study explores psychopharmacological prescribing patterns among pediatricians in Poland and Ukraine in the context of rising pediatric mental health needs following the ongoing war in Ukraine.</p> Methods <p>Data were collected via an online survey conducted between January and May 2023 among non-representative convenience samples of pediatricians in Poland (<i>n</i> = 43) and Ukraine (<i>n</i> = 161). The survey assessed demographic characteristics, self-reported frequency of and attitudes toward psychotropic medication use, and sources of knowledge influencing prescribing practices. Cross-country comparisons were conducted using descriptive and inferential statistical analyses.</p> Results <p>Nearly half of pediatricians in Ukraine reported prescribing psychotropic medications within the past 12 months, compared with approximately one quarter of pediatricians in Poland. Prescribing patterns differed between countries: selective serotonin reuptake inhibitors (SSRIs) were most commonly reported in Poland, whereas neurometabolic medications were frequently reported in Ukraine. Across both countries, self-reported awareness of psychotropic medication licensing and adverse effects was limited.</p> Conclusions <p>This exploratory study provides initial insights into pediatricians’ self-reported psychopharmacological practices in two distinct healthcare contexts. The findings highlight potential gaps in training, access to evidence-based resources, and system-level support for pediatric mental health care. Results should be interpreted in light of methodological limitations, including convenience sampling, reliance on self-reported data, and a relatively small Polish subsample.</p>