Introduction: Despite rising healthcare needs, Malaysia faces a concerning stagnant growth in the number of paediatricians, which has raised apprehension about meeting the nation’s future healthcare demands. The study aims to determine the factors influencing the final year medical students at public universities in their decision to pursue a career in paediatrics. Methods: A cross-sectional study was performed between October 2024 and April 2025, targeting final-year medical students from various public universities in Malaysia. Recruitment was facilitated through convenience sampling by university representatives. Data were gathered via an online self-administered questionnaire from the validated ‘Motivators for Medical Specialist Career Choice’ Questionnaire. The questionnaire comprised three parts: sociodemographic characteristics, speciality preferences, and 33 sub-constructs under seven main factors influencing speciality choice, assessed using a 5-point Likert scale. Results: A total of 420 students participated, with 164 students (39%) choosing Paediatrics as one of their first five choices of subspecialty. Upon analysis, only the personal factor was statistically significant (p-value=0.041, OR 1.943, CI 1.02,3.68) from simple logistic regression. This factor, along with patient care characteristics (p-value=0.155), was subjected to multiple logistic regression analysis. Only personal factor has shown a trend towards statistical significance (p-value=0.051, adjusted OR 1.80, CI 0.99,3.24). Conclusion: Personal factors are the single factor approaching significance that affects the career choice of paediatricians among current medical students in Malaysian public universities. Other factors were less significant due to the possibility of generational gaps with different paradigms of career perspectives.