The Prenatal-to-3 State Policy Roadmap guides state leaders on the most effective investments to ensure all children thrive from the start. Grounded in the science of the developing child and based on the most rigorous evidence available, the Roadmap details the state actions that foster the nurturing environments infants and toddlers need, and that reduce longstanding racial, ethnic, and socioeconomic disparities in access and outcomes. The Prenatal-to-3 State Policy Roadmap is an annual guide for each state to: Assess the wellbeing of its infants and toddlers and prioritize state PN-3 policy goals; Identify the evidence-based policy solutions proven to impact PN-3 policy goals; Monitor states’ adoption and implementation of the 12 effective Roadmap policies and strategies; Track the impact that policy changes have on improving the wellbeing of children and families and reducing disparities between racial and ethnic groups. In addition to each state’s Roadmap summary, we provide an overall summary of the progress that states have made over the last year toward full and equitable implementation of the 12 effective policies and strategies. (author abstract)