Abstract: Demographic transition over recent decades has led to population decline as well as changes in fertility and mortality rates and household structure in Serbia. Negative natural growth and large scale emigration were partly compensated by refugee flows from the former Yugoslav republics, but this large refugee inflow will not have significant impact on the future demographic changes of Serbia. In the light of the first results of the 2011 Census of population, households and dwellings in Serbia, this paper is focused on contemporary and past population trends and their implications. Along with depopulation, there has also been a decrease in number of households, whereas there has been an increase in the number of settlements with small number of population and the ones without inhabitants, with large regional demographic differences. Significant changes in population pose a number of economic and social challenges for the society and government in the field of public finances, pension fund, health insurance etc., but also in domain of spatial planning and regional development.