The purpose of this study was to examine the demographic and geographic disparities in the incidence of newborn babies with Neonatal Abstinence Syndrome (NAS) in the United States from 2012 to 2015. Specifically, I examined the prevalence of NAS according to geographic location (i.e. urban versus rural) and race while also controlling for mother’s insurance type, median household income, and trends over time. Additional analyses explored the relationship between NAS and delivery method, birth weight, and neonatal candidiasis that causes sepsis. Understanding the disparities in NAS and birth outcomes during this period (2012-2015) can help better target interventions for combating the health and economic burdens of NAS since maternal opioid use has continued to rise since 2015. Additionally, existing research into geographic disparities in NAS have only been region-specific. This study expands the scope of this literature by considering urban versus rural disparities across the country.