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Abstract Background Monitoring developmental milestones is essential for identifying at-risk populations and guiding effective intervention programs. Our previous report analyzed milestone attainment among Israeli children from 2016 to 2020. Using a similar methodology, this study examines trends in developmental milestone attainment within Israeli population from 2019 to 2024. Methods The dataset included over 1 million children with more than 5 million developmental assessments conducted at Maternal Child Health Clinics (MCHCs) across Israel. These assessments were used to calculate failure rates across four developmental domains: language, social, gross motor, and fine motor skills, along with parental concern about child development. Data were stratified by maternal characteristics, such as age, education, employment, and marital status, and by family sociodemographic factors, including ethnicity, degree of Haredi observance and socioeconomic status. We applied multivariable logistic regression to analyze the impact of different sociodemographic factors on the odds of failure to attain milestones, while controlling for confounding. Results A mild overall increase in milestone failure rates was observed from 2019 to 2023. Disparities based on maternal characteristics, particularly lower education, divorce status, unemployment, advanced maternal age, and immigration background, widened notably during periods of national disruption (COVID-19 and the war). In contrast, gaps associated with ethnicity and socioeconomic status remained stable or narrowed. Parental concern increased across most groups, particularly among Bedouin parents, suggesting growing awareness. Conclusions Maternal-level characteristics were strongly associated with elevated developmental risk observed from 2019 to 2023, and may be more sensitive to national crises. The findings underscore the importance of strengthening parental awareness, prioritizing early identification of high-risk families, and maintaining access to developmental services during emergencies.