Objectives: We sought to delineate the most commonly cited barriers to health and socialservices among North Dakotans with traumatic brain injury (TBI), and determine whether the types and quantity of perceived barriers differ by patients' residential location (urban vs rural), race/ethnicity (Caucasian vs Native American), and functional limitation (none, mild, moderate, and severe). Hypotheses: The types and quantity of perceived barriers significantly differ by (1) geographic location of residence, (2) race/ethnicity, and (3) functional limitation. Participants: A convenience sample was utilized comprising 117 North Dakotans with TBI. Methods: Participants were asked to complete and return a questionnaire that solicited a variety of information, such as demographics, nature of the TBI, service needs, and perceived barriers to accessing/using health and social services. Univariate and multivariate statistical methods were used to test the hypotheses. Results: The most commonly cited barriers to accessing and using health and social services were shortages of strong TBI advocates (47.0% stating that it was a barrier), inadequate knowledge of available services for TBI (46.2%), no centralized source for TBI information (46.2%), inadequate financial resources (45.3%), and lack of individualization of TBI services (41.9%). By geographic location, rural respondents were more likely than urban respondents to list long travel distances as a barrier to accessing services. By race, Native Americans were more likely than whites to cite lack of transportation and inadequate support from family members as obstacles. Conclusions: Persons with TBI, regardless of geography, race, or functional limitation, reported several obstacles for accessing health and social services in North Dakota. The most cited barriers were related to poor advocacy efforts and a lack of information. Many of the cited barriers could be lessened or alleviated through increased state efforts to address the needs of persons with TBI.