Baltimore’s Promise has a goal that all children are ready to succeed in school by the time they enter kindergarten. This means that all children will be able to demonstrate the foundational knowledge, skills, and behaviors that allow them to fully participate and succeed in the classroom and in school. This paper outlines why early care and education (ECE) matters; pathways that children may take to kindergarten and the associated outcomes; barriers families experience in accessing high-quality, affordable ECE; challenges faced by ECE providers; and the possible levers for change. The term ECE encompasses a range of programs and settings, including infant care, family- and center-based child care, Head Start, and pre-kindergarten. This paper focuses on the subset of ECE programs referred to as Early Learning and Development Programs (see box). (author abstract)