People with rare diseases face many barriers and inequities in accessing diagnosis, treatment, and comprehensive care. This burden is even greater among marginalized communities with rare diseases. The disparities fall into three major categories: lack of diversity in preclinical and clinical data; lack of diversity in the membership in and leadership of patient advocacy organizations; and limited health care and research access, from diagnosis to insurance coverage, to representation in rare disease clinical trials. The result is underrepresentation of marginalized groups and research that does not accurately reflect the comprehensive needs and experiences of the impacted population. This session will highlight these challenges, discuss solutions already being implemented, and imagine what true health equity for people with rare diseases would be.