The Short Answer
Fax is still in everyday use in Japan, Germany, the United States and Canada, and it hangs on in parts of healthcare in Australia and Europe. The numbers are falling almost everywhere, but not at the same speed. Germany has dropped sharply in a single year. US hospitals have barely moved.
The reasons are less about love of old machines than about the other end of the line. People keep faxing because a government office, a hospital or a supplier they deal with still expects it.
Fax Use by Country: The Latest Percentages
There is no global fax census, so these figures measure different things: households in Japan, companies in Germany, hospitals in the US. Use them to see each country's own picture, not to rank one against another.
| Country | Latest figure | What it measures | Year |
|---|---|---|---|
| Japan | 23.6% | Households that own a fax | 2025 |
| Germany | 18% | Companies with 20+ staff that fax regularly | 2025 |
| United States | 81% receive, 74% send | Hospitals that often or sometimes exchange care records by mail or fax | 2025 |
| Canada (Ontario) | 88% | Physicians estimated to still use fax to share patient information | Cited 2025 |
| Canada (Manitoba) | 85% | Consultations still sent by fax or mail | 2026 |
| Australia (north-west Tasmania) | 53.4% | Health professionals who chose fax as their main way to send letters | 2018 |
We could not find a reliable national percentage for the UK, France, South Korea or Australia as a whole, so they are not in the table. Treat any neat worldwide ranking you see with suspicion.
Japan: Fewer Homes, but Still One in Four
Japan is the only major country where fax is a household item. In the government's Communications Usage Trend Survey, ownership has fallen steadily:
- 2011: 45.0% of households
- 2020: 33.6%
- 2024: 24.5%
- 2025: 23.6%
Age explains a lot of what remains. In the 2025 data, only 1.0% of households headed by someone in their 20s had a fax, compared with 14.1% in their 40s and more than 30% among those aged 60 and over. Geography matters too, from 33.7% in Nara down to 9.1% in Okinawa.
Why it lasts: fax suits handwritten notes and drawings, older people find it easy, and schools, clinics and local offices have long relied on it. Changing all that has proved hard. When the government tried to remove fax from its own offices in 2021, ministries lodged about 400 formal objections.
Germany: The Fastest Fall
You will still see the figure that three quarters of German companies fax. That was true, but it is no longer the whole story. Germany's digital association Bitkom has two useful series, and both are heading down.
- Any fax use: 95% of companies in 2018, 88% in 2022, 82% in 2023 and 77% in 2024.
- Regular fax use: 33% in 2023, 30% in 2024 and 18% in 2025.
The two series ask different questions, so do not read 77% to 18% as one drop. Both surveys cover companies with 20 or more employees.
Why it lasts: dealing with officialdom. In Bitkom's 2024 survey, 56% of companies that still fax said it was unavoidable for communicating with authorities. Only 7% thought it was more secure than digital options, and 6% kept it as a backup. Most of them have also left the old machine behind, with 72% using digital fax that arrives like an email.
United States: Healthcare Keeps It Alive
In the US, the clearest numbers come from hospitals. Federal data from the American Hospital Association IT survey shows how often hospitals swap summary of care records with outside organizations by mail or fax. The survey groups the two together, so these figures are not fax alone.
| Often or sometimes use mail or fax | 2018 | 2023 | 2025 |
|---|---|---|---|
| To send records | 71% | 67% | 74% |
| To receive records | 76% | 75% | 81% |
Digital networks have grown a lot over the same period, yet mail and fax went up between 2023 and 2025. Newer systems have been added alongside fax, not in place of it.
Why it lasts: hospitals run many different record systems, and a fax number reaches a small clinic that none of them connect to. Fax is also accepted under HIPAA, so there is no legal push to drop it. Our post on why businesses still use fax covers those rules, along with law and finance.
Canada: A Provincial Problem
There is no single national figure for Canada, because health care is run by the provinces, but what exists points the same way.
- Ontario: an estimated 88% of physicians still use fax to share patient information, and the health ministry has put the total at about 152 million faxes a year. In 2023 the province said it would replace them within five years.
- Manitoba: 85% of consultations still go by fax or mail, and only 19% of physicians can share information electronically with colleagues, according to Doctors Manitoba in January 2026.
Why it lasts: a doctor who moves to digital referrals still has to fax anyone who has not, so every clinic ends up running both. The Ontario Medical Association has warned that scrapping fax overnight would "create chaos" in the system.
The UK, Australia and Austria: Pushing It Out
Some countries have decided to force the issue in healthcare, with mixed results.
- United Kingdom: when the Royal College of Surgeons counted 8,209 fax machines in NHS hospital trusts in England in 2018, the government banned new purchases from January 2019 and set a March 31, 2020 deadline to stop using them. A 2019 check of the largest users found only 42% of their machines had gone. We found no national count since then.
- Australia: a 2018 study in north-west Tasmania found 53.4% of 204 health professionals used fax as their main way to send letters, and 92.4% of the GPs and GP registrars among them. It is one region and it is dated, but national figures are scarce. My Aged Care announced the end of fax referrals in 2023.
- Austria: the exception allowing health data to be sent by fax ended in January 2025, with a transition period to June 30, 2026 and fines of up to EUR 10,000. The start was rough. German press reported X-rays and doctors' letters moving by courier and taxi on USB sticks.
Four Reasons Fax Refuses to Die
Different countries, but the same few causes keep coming up.
- Someone else requires it. Fax only ends when the other side stops asking for it. That is the 56% of faxing German companies who say authorities leave them no choice.
- It works across systems. Any fax number can reach any other, with no shared software, login or contract. Many digital health systems still cannot say the same.
- Law and habit move slowly. Forms, rules and office routines were all written around fax. Japan had to scrap more than 1,000 regulations just to retire the floppy disk.
- The remaining users are older. Japan's age figures show it plainly. Much of the remaining decline will come from generations changing, not from anyone being convinced.
If You Have to Fax One of These Countries
You may have no fax machine and still run into a clinic in Tokyo, a German agency or a US hospital records office that wants one. You do not need the hardware. With unofax you upload a PDF, enter the number and pay per page, with a delivery confirmation at the end. It costs 59 cents (AUD) a page, there is no account or subscription, and it reaches Japan, Germany, the US, Canada, the UK and Australia, among others. Our guide to sending international faxes online covers country codes and number formats.
The Bottom Line
Fax is shrinking, but unevenly. Roughly one in four Japanese households still has one, fewer than one in five larger German companies fax regularly, and most US hospitals and Canadian doctors still rely on fax or mail for at least some records. It will last for as long as the offices at the other end keep asking for it.