We looked into nine indicators to rank and compare the humanitarian access levels worldwide. Affected populations in more than 50 countries are not getting proper humanitarian assistance due to access constraints. Humanitarian access has deteriorated in Colombia, Iraq, Myanmar, Nigeria, Pakistan, and Somalia over the past six months. 13 new countries entered the ranking since the latest ACAPS Humanitarian Access report released in August 2018. Physical constraints and restriction/obstruction of access to services and assistance are the most common challenges.