Effective communication is often disrupted in children with complex communication needs. In healthcare provision, this can negatively impact clinical decision-making, treatment choices, and cause frustration among individuals. Pediatricians, as specialists who consistently monitor the child and are the first point of contact for parents seeking help, need additional knowledge and strategies to tailor their services to the specific communication needs of these children. However, research shows that many feel insufficiently competent and that environmental factors within the healthcare system further complicate the situation. As a strategy to overcome these obstacles, many cite collaboration with other professionals and the use of augmentative and alternative communication (AAC) to provide necessary communication support. Although increasing literature highlights the growing number of children with complex communication needs, the importance of using AAC in healthcare, and the collaboration between pediatricians and speech therapists, similar research in Croatia is scarce. This study aimed to explore the experiences of Croatian pediatricians in working with children with complex communication needs and methods of AAC. A total of 38 pediatricians were surveyed, and differences were analyzed based on years of experience and the presence of a speech therapist within their practice. Despite being aware of the importance of communication with these children, pediatricians cite time pressure and a lack of specific knowledge in this area as their biggest challenges. Many are familiar with various communication aids, but only a few have personally used them. It was found that pediatricians with more years of experience perceive working with children with complex communication needs as more challenging compared to those with fewer years of experience. No differences were found in other examined variables based on years of experience or the presence of a speech therapist. Pediatricians believe they need training in communication disorders and AAC, but also point out systemic issues that would hinder the application of what they have learned. Through collaboration with various professionals, ensuring necessary resources, and applying specific strategies, the quality of services provided to children with complex communication needs would improve, as would the job satisfaction among pediatricians.