Purpose: Early use of preventive services in children can prevent costly disease and promote a lifetime of well-being. Childhood immunizations and preventive dental visits are some of the earliest measures parents can take to equip children against common, harmful infectious diseases. The American Academy of Pediatrics (AAP)’s Bright Futures framework recommends timely immunization benchmarks for 24 – 35 month olds to reduce the risk of infection. Healthy People 2020 (HP2020) has set a goal of 80.0% of children 19 - 35 months to achieve the recommended series of immunizations; this is an increase from a baseline of 44.3% in 2009. Both the AAP and American Academy of Pediatric Dentistry recommend that children see a dentist by the eruption of their first tooth, or first birthday, to prevent dental caries and oral disease. HP2020 has set a goal of achieving 49.0% of individuals 2 and older to use dental care in the past year; this is an increase from a baseline of 44.5% in 2007. Both public health measures are not fully utilized in any region and represent an area for improvement. Methods: Publicly available data from the state health department were queried to look at use of preventive services for 24 – 35 month olds by county in 2014. Immunization series data was measured for all children within this age range registered in the state’s immunization information database. Full utilization was defined as use of the DTaP, polio, MMR, Haemophilus influenzae type b, hepatitis B, varicella, and PCV vaccines. Preventive dental services were measured as any diagnostic (e.g. exam, radiographs) or preventive code (e.g. dental cleaning, fluoride) claimed for children enrolled for at least 90-continuous days in one of three state health care programs. Results: There are 87 counties in this northern Midwest state. The percentage of 24 – 35 month olds that completed the full immunizations schedule ranged from 31.4 – 81.5% of each county (overall state average 59.0%). One county exceeded the HP2020 goal and 14 were within 10 percentage points. The percentage of 24 – 35 month olds enrolled in a state health care program that used preventive dental care ranged from 0.0 – 36.0% of each county (overall state average 10.0%). All counties fell well below the HP2020 goals for dental use. Rural counties showed lower percentage of use of both immunizations or preventive dental visits compared with urban or suburban counties. Conclusions: Use of both immunizations and preventive dental visits can be improved in young children in this Midwestern state. Public health strategies should look to facilitate access to both of these vital services, possibly by combining medical and dental care access points.