OBJECTIVES: Japanese government is now trying to introduce cost-effectiveness analysis into its healthcare system because of severe budget constraint.  It would be important to elucidate the basic attitude of physicians towards health care resource allocation on this occasion. METHODS: A web-based survey for physicians was carried out in Japan, adjusting for age, sex, specialty, and hospital scale, between February and March in 2015. The questionnaire consisted of two main inquiries and related questions. The 1^st question was about medical decision to choose between two screening test for a population at low risk for colon cancer. Test A was more cost effective than test B, but was too expensive to be given to everyone in the population. The option 1 was that all subjects received test B and subsequently the death of 1,000 people was prevented, while the option 2 was that a half of the subjects were selected by lottery and received test A, preventing the death of 1,100 people as a consequence.  The 2^ndquestion was concerning priority setting between two types of diseases differing the treatment cost(disease A: ￥10 million per patient; disease B: ￥2 million per patient). The physicians were asked to choose some possible combinations of numbers of people treated if the total expenditure were limited to 100 million yen. RESULTS: Out of 1,089(male/female=891/198) respondents, 699 chose the option 1 in the 1^st question. In question 2, 187 chose the least utilitarian combination(A;8, B;10), 125 chose 2^nd combination(A;6, B;20), 277 chose 3^rd one(A;4, B;30), 76 chose 4^thone(A;2, B;40), and 424 chose the most utilitarian option(A;0, B;50). CONCLUSIONS: We investigated the basic attitude of physicians towards healthcare resource allocation in Japan in a setting of budget constraints, which revealed that fairly extreme utilitarian selection was the more popular among them than expected.