Introduction: A recently released report, the National Survey of Pathology Workforce 2011, has painted a bleak future for clinical pathology services in terms of a looming major workforce shortage. Approach: A review is undertaken of the current pathology workforce situation to determine the key contributing issues, future demands, workforce needs and strategic solutions. Findings: A workforce crisis in pathology is upon us, with approximately a third of the total workforce expected to leave within the next five years. This represents a real threat to the future capacity of the workforce to sustain quality services at current levels and the likely growth of demand for pathology testing into the future. Conclusion: Four strategies are recommended to address the future pathology workforce needs in Australia through leadership and workforce development. These are; increasing supply of the workforce; redistributing the workforce from areas of lower to higher demand; improving productivity; and reducing demand for pathology services.