RURAL IMMUNOLOGY CARE remains significantly less accessible than primary care services for people with primary immune disorders, according to a national analysis of healthcare resources across the USA. Researchers sought to quantify geographic access to expert clinical immunologists, infusion centres, and federally qualified health centres to better understand disparities in specialist care. By contrast, expert clinical immunologists were underrepresented in rural locations nationally, while both expert clinical immunologists and infusion centres were underrepresented in the six state and territory analysis. Rural representation of expert clinical immunologists was lower than expected using Rural Urban Commuting Area classifications (r=−2.68), while infusion centres also showed significant rural underrepresentation (r=−2.91). Geographic information system mapping further demonstrated the limited availability of specialist services, with rural coverage by expert clinical immunologists identified in only six states.