Each year, the New York City homeless family shelter system provides transitional housing for nearly 20,000 homeless children. While the health care needs of these children are substantial, there is currently no system-wide mechanism for ensuring that they have access to appropriate medical care. This report analyzes information from the Homeless Child Health Care Inventory, a survey conducted by Montefiore Medical Center's Division of Community Pediatrics, to examine the adequacy of health care resources available to the homeless children in New York City. Results showed that available health care resources varied considerably throughout the shelter system and that nearly 50% of homeless children in New York City did not have access to appropriate medical care.