Objective: An investigation of consumers' perceived barriers to access paediatric speech pathology services. Design: Self-administered, mail-out questionnaire. Setting: Rural and remote New South Wales (NSW). Subjects: Three hundred and twenty-nine members of the NSW branch of the Isolated Children's and Parents' Association. Results: Consumers living in rural and remote areas experience a number of barriers that affected their ability to access speech pathology services. These barriers include the lack, and limited choice, of speech pathologists in rural areas; long distances to travel to access services, expensive travel costs, lack of public transport; poor awareness of speech pathology services; and delays in treatment due to waiting lists. Conclusion: Barriers to access paediatric speech pathology services limit rural and remote consumers' usage of health services, regardless of need, indicating a possible inequity if compared to larger, more accessible urban areas.