A nationwide cardiac pacing survey has been undertaken annually in South Korea. We compared the 2010 survey with the 2000 one. Data were collected from the cardiac implantable electronic device manufacturers and distributors. The implantable cardioverter defibrillator was not included in this survey. In 2010, the number of total implants, new implants, and replacements were 2932, 2153, and 779, respectively. Those numbers are 162%, 133%, and 295% increases, respectively, as compared with the 2000 data. A number of new implants per million population was increased from 19 to 43. However, according to the 2009 world survey, it was still lower than other Asian Pacific countries including Japan (272), Taiwan (172), Hong Kong (124), and Singapore (94). As for the pacing mode, VVI(R) was decreased from 38% to 26%, and DDD(R) was increased from 44% to 60%. The major indications for new implants were a sinus node dysfunction (41%) and an advanced atrioventricular block (54%), and female patients constituted 59% of total implants, which were similar to the 2000 survey. Possible reasons for a small number of cardiac pacing implantation in South Korea, as compared with other Asian countries with similar economic background, could be differences in population profiles, physician���s attitudes, cultural backgrounds, reimbursement problems, and a low incidence of conduction system disorders. In summary, the cardiac pacing implantation has markedly increased for the last 10 years. The dual chamber pacing has been replacing the single chamber pacing. Why the implants in South Korea are small is still questioning.