Abstract: During times of fiscal restraint, many hospitals are questioning library budgets. As a result, hospital library managers are faced with justifying their current levels of staffing. Increases in a library's staffing complement are even harder to realize. The purpose of our research was to learn more about the extent of volunteer use in hospital libraries and to increase our understanding of the issues and challenges related to using volunteers. The target population of the research was managers of Ontario hospital libraries. To identify potential respondents, the membership listings for the Canadian Health Libraries Association and Ontario Hospital Libraries Association were consulted. DOCLINE® yielded additional names of library managers. In April 2003, a mail survey questionnaire was sent to 89 Ontario hospital library managers. Findings relating to staffing issues in Ontario hospital libraries are discussed with particular reference to two key factors: the extent of volunteer use and the adequacy of staffing. This research has highlighted a number of implications for practice, including the need for (1) prescriptive staffing standards and formalized volunteer-use policies; (2) advocacy, lobbying, and networking with other components of the health care system; and (3) formalizing staffing planning in hospital libraries to ensure they are staffed with appropriate personnel.