The middle spotted woodpecker was formally described by the Swedish naturalist Carl Linnaeus in 1758 in the tenth edition of his Systema Naturae under the binomial name Picus medius.

[5][6] This genus had been erected by the German ornithologists Jean Cabanis and Ferdinand Heine in 1863 with the middle spotted woodpecker as the type species.

The middle spotted woodpecker occurs only in Europe in the Palearctic, from northern Spain and France east to Poland and Ukraine, and south to central Italy (where local), the Balkan Peninsula, Lithuania, Latvia, Turkey, the Caucasus, and Iran.

It prefers deciduous forest regions, especially areas with old oak, hornbeam and elm, and a patchwork of clearings, pasture and dense woodland.

The middle spotted woodpecker lives predominantly on a diet of insects as well as their larvae, which it finds by picking them from branches and twigs rather than hacking them from beneath the bark.