Childcare access is critical to economically healthy communities, aiding in early child development, caretakers being able to work, and supporting local industries and businesses. While the importance of affordable childcare cannot be overstated, too often people and families in North Carolina live in childcare deserts, areas that lack adequate childcare stock. In North Carolina, 44 percent of rural residents live in a childcare desert, a number that is comparable to suburban and urban residents in the state. This means that childcare access is a challenge throughout the state. In this report, childcare access and affordability are explored, as well as factors that contribute to childcare challenges and what is being done in the state to address these challenges.