Background: For both pediatric surgery fellowship applicants and programs, the interview process is ever-increasingly competitive and time intensive. We hypothesized that the number of interviews accepted and attended by applicants and the number of interviews offered by programs are increasing over time, which may not be beneficial to either party. Methods: We analyzed pediatric surgery fellowship program and applicant data from Thalamus, a GME interview management program, between 2018 and 2020. The number of interviews offered by programs and received by applicants and the number of interviews completed by both applicants and programs were analyzed. Cancellations, program fill time, and regional analysis of programs and applicants were also captured. Analyses were performed using descriptive statistics and Chi-Square analysis. Results: Our dataset included 34, 41, and 45 programs, which represented 75%, 91%, and 95% of all programs in 2018, 2019, and 2020, respectively. For applicants, the difference between median number of interviews received versus completed were 0, +1, and +0.5. For programs, the difference between interviews offered versus completed was greater (+3, +2, +4). Median cancellations per program were 7 in 2018, 5 in 2019, and 3 in 2020, and the median amount of time from first interview scheduled to 80% full was 95.49, 43.32, and 44.13 minutes, respectively. We found an association between region of applicant and program interviewed (p<.001). As all programs offered only one position per interview cycle, a mean of 22 of 23 interviews (95.72%) per program do not result in a matched candidate. Conclusions: The vast majority of pediatric surgery fellowship interviews do not result in a successful match. Applicants, on average, attend all interviews offered, while programs offer more interviews than they complete. Next steps include creation of program-level performance data on scheduling, cancellations, and ideal applicant profiles to maximize the Pediatric Surgery interview process.