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Geospatial Analyses of Accessibility to Down Syndrome Specialty Care. OBJECTIVE: To assess whether the location of 71 Down syndrome specialty care clinics in the US make them inaccessible to a considerable portion of the American population. STUDY DESIGN: Using a population-based representative sample of 64 761 individuals with Down syndrome and a Google Maps Application Programming Interface Python program, we calculated the distance each patient with Down syndrome would need to travel to reach the nearest clinic. Two conceptualizations were used-the state fluidity method, which allowed an individual to cross state lines for care and the state boundary method, which required individuals receive care in their state of residence. RESULTS: Almost 1 in 5 US individuals face significant geographic obstacles to receiving specialty care. This finding is especially prominent in the South, where >33% of patients with Down syndrome must travel >2 hours to reach their nearest clinic. CONCLUSIONS: Down syndrome specialty care clinics are inaccessible to a considerable portion of American society. Innovative usage of technology might be useful to minimize these disparities in healthcare accessibility.