Background <p>Although medical cannabis has been legally available by prescription in the Netherlands for more than two decades, few individuals use it. Instead, most people who use cannabis for therapeutic purposes continue to obtain it through unregulated, illicit sources. This study examined barriers to accessing prescribed cannabis from the perspectives of people using non-prescribed cannabis for medicinal purposes in the Netherlands.</p> Methods <p>Semi-structured qualitative interviews were conducted with thirty-three participants who used non-prescribed cannabis to manage somatic or psychiatric symptoms. Data collection and analysis were guided by Levesque and colleagues’ patient-centred access to care framework, which encompasses five dimensions of accessibility: affordability, availability, approachability, appropriateness, and acceptability. The framework provides a multidimensional view of access within healthcare systems. A deductive coding approach and thematic analysis were applied. Reporting followed the COREQ guidelines.</p> Results <p>Participants reported barriers across all five dimensions of the access to care framework. Key challenges included the perceived high cost of prescribed cannabis, the limited availability of prescribing physicians, restrictive medical guidelines, and a lack of accurate and accessible information. Additional barriers were the perceived poor fit between services and patient needs, particularly in terms of cannabis product variety and effectiveness, as well as persistent stigma surrounding cannabis use. While most participants expressed a preference for prescribed cannabis in principle—valuing its safety, quality, and legitimacy—these perceived barriers prevented or dissuaded them from access through the formal healthcare system.</p> Conclusions <p>Despite its longstanding legal status, access to prescribed cannabis in the Netherlands remains constrained by significant structural, informational, and sociocultural barriers. Addressing these barriers requires coordinated policy reforms and healthcare responses to ensure equitable, patient-centred access to prescribed cannabis and reduce reliance on unregulated sources.</p>