Children and youth with special health care needs (CYSHCN) are those who have or are at risk for ongoing chronic physical, developmental, behavioral, or emotional conditions¹, such as autism, attention deficit hyperactivity disorder and asthma. CYSHCN frequently require specialized health services or equipment to help manage or treat their underlying medical, emotional, or developmental conditions. Such services include care from pediatric specialists, mental health treatment and counseling, physical or occupational therapy, medical supplies, durable medical equipment (such as wheelchairs, walkers, braces), hearing aids, or home health care. CYSHCN vary widely according to the number, type, and level of special services or equipment they need as a result of their chronic health conditions. This chapter reviews what is known about the quality of care for CYSHCN and the ways that quality varies by insurance and race/ethnicity.