Abstract Aim of Study To examine changes in authorship patterns in the articles published in the Journal of Pediatric Surgery (JPS) over the last three decades (1981–2010), and to analyze why they took place. Methods Data for analysis were obtained from the JPS over three five-year periods (1981–1985, 1991–1995, and 2006–2010). All original papers (3740), case reports (884), and correspondence (236) were separately examined and analyzed. For investigation of percentage distribution of publications (original papers and case reports), combined groups of papers, with 1 to 3, 4 to 5, 6 to 9, and over nine authors were formed. Justified (ethical, acceptable) and unjustified (unethical, unacceptable) reasons for authorship changes were defined according to the International Ethical Guidelines. Comparisons among groups were made with Kruskal-Wallis tests, taking p<0.05 as significant. Results The number of authors of original papers and case reports increased significantly in consecutive periods (p<0.001). The same pattern was observed in letters (p<0.01). The percentage of papers with less than 3 authors significantly declined, whereas those with 4 to 5 authors did not change. Manuscripts with more than 6 authors significantly increased, and a similar pattern was seen in case reports. Conclusions This striking increase in the number of authors per article was evident in other medical journals as well, and reflects a progressive complexity in academic work along with the need for building resumes rich in publications. It can be anticipated that this tendency will continue in the future.