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Rates of maternal opioid use and neonatal abstinence syndrome (NAS) have sharply increased in recent years. In this brief, we use hospital and emergency room patient discharge data to investigate incidence rates of neonatal abstinence syndrome (NAS) across counties in California. We also use data on the locations of opioid-use disorder treatment facilities providing medication-assisted therapy to pregnant women as well as the locations buprenorphine-waivered prescribers to assess the availability of treatment (measured by driving distances and driving times) in each county and zip code throughout the state. The data reflect that NAS incidence rates are greater in rural counties in the state’s northern and eastern regions. These areas also tend to be farther from treatment facilities providing methadone and buprenorphine treatment for pregnant women and from buprenorphine-waivered prescribers. Though this analysis does not identify a causal relationship, these findings suggest that proximity to treatment for opioid-use disorder and NAS incidence rates are correlated.