The dynamic development of clinical immunology in Europe began in mid 1980s, and was continued in Poland shortly thereafter. In 1993 the first national consultant in the field of clinical immunology was appointed in Poland. A milestone was the establishment of the Polish Working Group for Primary Immunodeficiencies (PGR for PID) in 2005. Since then, a network of numerous paediatric and internal medicine centres has been created within the Group, facing and resolving new challenges in the field. The study presents the organization of care for patients with primary and secondary immunodeficiencies in Poland, analyzes the staffing situation and patients' access to diagnostics and treatment between late 1980’s and 2024. The summary presents the achievements resulting in improved diagnostic efficiency, shortening the delay in the diagnosis of Inborn Errors of Immunity (IEI)/primary immunodeficiencies (PID), and better access of patients to therapy within drug programs, largely carried out at home. The causes hindering the development of specialization are also analyzed. The most important among them are the lack of systemic support on the part of medical care organizers and the lack of motivation of young doctors to pursue specialization. The main goal is to improve diagnostic and therapeutic procedures for PID patients, including newborn screening, highly specialized, genetic test regardless where they are implemented. It can be only achieved with their better financing. An essential problem is the lack of an epidemiological or clinical IEI registry.