The Pale-billed Woodpecker is restricted to Central America, although within this region it is widely distributed. It occurs on the Atlantic coast from northeastern Mexico, in southern Tamaulipas, south continuously to the Atlantic slope in western Panama in Bocas del Toro (Monroe 1968, Land 1970, Ridgely and Gwynne 1989, Stiles and Skutch 1989, Howell and Webb 1995). On the Pacific slope, it occurs as far north as southern Sonora, northwestern Mexico (van Rossem 1945). Russell and Monson (1998) suggested that it may now be extirpated from Sonora, but there still are occasional reports from there (Héctor Gómez de Silva, pers. comm.). Otherwise, it occurs from Sinaloa, in northwestern Mexico, south continuously to western Panama in western Chiriquí (Monroe 1968, Land 1970, Ridgely and Gwynne 1989, Stiles and Skutch 1989, Howell and Webb 1995).
This species primarily occurs at lower elevations. It ranges from the lowlands up to 2000 m in Mexico (Howell and Webb 1995), but usually the upper elevational limit is lower farther south: 1500 m in Honduras (Monroe 1968), 1500 m on the Pacific slope in Costa Rica but to only 1000 m on the Atlantic slope there (Stiles and Skutch 1989), and to 1200 m in Panama (Ridgely and Gwynne 1989).
The Pale-billed Woodpecker is resident throughout its range (Land 1970, Ridgely and Gwynne 1989, Stiles and Skutch 1989, Howell and Webb 1995).