Results of the 2018 ASHP national survey of pharmacy practice in hospital settings pertaining to the pharmacy workforce are presented.Pharmacy directors at 4,897 general and children's medical-surgical hospitals in the United States were surveyed using a mixed-mode method of contact by mail and email. Survey completion was online. IMS Health supplied data on hospital characteristics; the survey sample was drawn from the IMS hospital database.The survey response rate was 16.6%. The results indicate that inpatient staffing has increased for both pharmacists and pharmacy technicians. More than half of the respondents reported shortages of pharmacy managers, experienced technicians, and experienced pharmacy technicians with sterile compounding experience. More than half of the respondents reported an excess of entry-level frontline pharmacists. The perceived shortage of pharmacists is in decline, while the perceived shortage of pharmacy technicians, especially those with years of experience, is increasing. Pharmacists commonly chair multidisciplinary committees within health systems, and pharmacy leaders often report directly to the chief executive officer or chief operating officer; they are often responsible for reporting quality information associated with medication use to the health system's board. The use of a pharmacist credentialing and privileging process beyond licensure has increased over the past 4 years. Attention is being devoted to stress in the work place and addressing burnout among healthcare professionals, including pharmacists.The profession is fostering a workforce that is appropriate in composition, sufficient in number, and has the competence to improve the value and safety of medication use.