The COVID-19 pandemic had a significant impact on the economy, infrastructure, and political and social landscape, magnifying disparate health barriers and socioeconomic inequalities for children. This chapter will focus on the impact that COVID-19 had on access to care through an assessment of economic, structural, political, and social barriers. These include but are not limited to school closures, social isolation, reduced access to in-person care, impact on caregivers, and diversion of social safety net structures (Vicetti Miguel et al., J Pediatric Infect Dis Soc 11(Suppl_4):S132–S140, 2022). It is essential to systematically evaluate barriers to care and employ mitigation strategies while reinforcing future pandemic and emergency preparedness to minimize care disruption to pediatric populations.